General Considerations
Single Organ Vasculitis - Cutaneous Vasculitis
Systemic Vasculitis with skin involvement
The section on vasculitis in general is found here. The anatomy of the blood vessels and general principles of vasculitis are covered on this webpage.
Swan et al (2015) reported on 42 dogs with vasculitis and 3 had cutaneous involvement. 11 of their 42 were a primary vasculitis and 6 of these involved the capillary or post capillary venule! Many of their cases do not meet the criteria of vasculitis as outlined by the Chapel Hill Consensis of Vasculitis for humans.
Swann JW, Priestnall SL, Dawson C, Chang YM, Garden OA. Histologic and clinical features of primary and secondary vasculitis: a retrospective study of 42 dogs (2004-2011). J Vet Diagn Invest. 2015; 27: 489-496.
General Comments
CRGV is a disease first described in Greyhounds in the southern USA and called "Alabama Rot". It is well recognised in the UK in a variety of breeds including hounds and rural dogs. Toy breeds are not reported to be affected.
The pathogenesis is not well understood. It is classified as a Thrombotic Microangiopathy (TMA) because there is thrombosis in small vessels. TMAs include hemolytic uremic syndrome.
Initialism
CRGV
Clinical presentation
The lesions vary from erosions to ulcers on teh face, tongue, abdominal skin, distal limbs including central portion of the pads, and scrotum. There are systemic signs referable to uremia from acute kidney injury (AKI). Hemorrhage from thrombocytopenia occurs.
Dermatopathology.
Microscopic finding are those of erosion and coagulative necrosis of the dermis. Dermal arterioles, when vascular lesions are present, have fibrinoid necrosis, karyorrhectic debris and thrombosis.
Holm LP, Steven KB, D. J. Walker DJ. Pathology and Epidemiology of Cutaneous and Renal Glomerular Vasculopathy in Dogs. J Comp Path 2020; 176: 156-161.
General Comments
Dermal arteritis of the nasal philtrum is a vasculitis of arteries and arterioles of the nasal philtrum.
Initialism:
DANP or DVNP
Breeds:
Saint Bernard
Clinical signs:
The main lesion is ulceration of the nasal philtrum, usually that bridge the midline between the nares. This lesion can bleed and result in sufficient hemorrhage to require emergency intervention.
Dermatopathology
The lesion of importance is vasculitis and vascular changes of the medium arteries beneath an area of ulceration or infarction. Many cases have endothelial proliferation and extracellular matrix deposition between the internal elastic lamina and the endothelium. Sometimes neutrophils and chromatin debris are present.
Comments:
Many people call this vasculitis of large arteries. While the vessels look big on histology, this is not a large vessel vasculitis - it is a medium vessel vasculitis. Many cases are diagnosed on typical clinical presentation.
The cause of this vasculitis is unknown.
Many large breed dogs can get this. Fleischman et al (2023) called this disease in German shepherd dogs nasal alar arteriopathy of German shepherd dogs. They had 14 cases, and 5 had DLE and mucocutaneous pyoderma.
Fleischman DA, Mauldin EA, Lowe A, Cain CL, Bradley CW. Clinical and histopathological features of rostrolateral nasal alar arteriopathy of German shepherd dogs. Vet Dermatol. 2023; 34: 441-451.
Souza CP, Torres SMF, Koch SN, Bernardi de Souza L. Dermal arteritis of the nasal philtrum: a retrospective study of 23 dogs. Vet Dermatol 2019; 30: 511-E551
Torres SM, Brien TO, Scott DW. Dermal arteritis of the nasal philtrum in a Giant Schnauzer and three Saint Bernard dogs. Vet Dermatol. 2002; 13: 275-281.
Dogs develop a rare disease of the skin that is nodular and neutrophilic. Affected dogs have multiple nodules in their skin, but can have extracutaneous disease including oral only disease, and arthritis. Some dogs have fever and neutrophilia.
The histological lesions are perivascular to diffuse and nodular. They are dominated by neutrophils, but may have eosinophils too. Vascular injury is considered to be secondary to metabolites from neutrophils. Veins are often involved because of this.
Bradley CW, Cain CL, Wong TS, Ferracone JD, Goldschmidt KH, Mauldin EA. Discriminatory features of acute eosinophilic dermatitis with oedema (Wells-like syndrome) and sterile neutrophilic dermatosis (Sweet's-like syndrome) in dogs. Vet Dermatol. 2019; 30: 517-e157.
Johnson CS, May ER, Myers RK, Hostetter JM. Extracutaneous neutrophilic inflammation in a dog with lesions resembling Sweet's Syndrome. Vet Dermatol. 2009 Jun;20(3):200-5. doi: 10.1111/j.1365-3164.2009.00746.x. Epub 2009 Apr 16. Erratum in: Vet Dermatol. 2010 Apr;21(2):232. PMID: 19392767.
General Comments
Initialism:
Breeds:
Clinical signs:
Dermatopathology
Comments:
Type III rx
Virus
Adverse reaction
Shar Pei
FIP in cats
Often cell poor
Dermatomyositis
Collies and Shelties esp.
often disappear when animals develop maturity
same distribution
Jack Russell Terrier
3 months to 11 years
same classical distribution
some had leucocytoclastic vasculitis
German shepherd dogs
Familial cutaneous vasculopathy of GSD (CVJ 35: 763)
distribution
footpads, ears, face/nasal planum, tip of tail
Treatment - no response to Antibiotics, CCS or Dapsone
Age - 4-7 weeks of age
Histo - nodular dermatitis (mononucls, and Neuts) of footpads. Vessels - minimal lesions Collagenolysis of skin of footpads, distal limbs, and ventral thorax
Scottish terrier
3-4 weeks of age
leukocytoclastic vasculitis
facial especially
St Bernard and Giant schnauzer
Proliferative vasculitis/arteritis of nasal philtrum
Vet Dermatol 2002
Cutaneous Vasculopathy of Greyhounds
Bartonella
Southern BL, Neupane P, Ericson ME, Dencklau JC, Linder KE, Bradley JM, McKeon GP, Long CT, Breitschwerdt EB. Bartonella henselae in a dog with ear tip vasculitis. Vet Dermatol. 2018 Dec;29(6):537-e180.
Small vessel vasculitis