Pemphigus in dogs: An update

Abstract

Pemphigus in dogs is an autoimmune vesicobullous to pustular dermatosis characterized by acantholysis and intraepidermal blister formation, most commonly manifesting as pemphigus foliaceus in middle?aged animals. Autoantibodies directed against desmosomal proteins (primarily desmoglein?1, desmoglein?3, and desmocollin?1) induce complement activation, neutrophilic inflammation, and progressive crusting, with clinical forms ranging from superficial (foliaceus, erythematosus, vegetans) to deep, mucosa?involving variants (vulgaris, paraneoplastic). Diagnosis is based on distribution and morphology of lesions, cytology demonstrating acantholytic keratinocytes, characteristic histopathology, and immunofluorescence, supplemented by newer tools such as disease activity indices, eosinophilic infiltrate scoring, C?reactive protein, and antidesmocollin assays. Management centers on staged immunosuppression with glucocorticoids and steroid?sparing agents, with emerging roles for calcineurin and Bruton’s tyrosine kinase inhibitors, mycophenolate, oclacitinib combinations, chrysotherapy, and plasma exchange. Prognosis is generally fair for superficial forms but guarded for deep and paraneoplastic variants.