Todayโs path rounds are on ๐ก๐๐ฉ๐๐ญ๐จ๐๐ฎ๐ญ๐๐ง๐๐จ๐ฎ๐ฌ ๐ฌ๐ฒ๐ง๐๐ซ๐จ๐ฆ๐!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐๐ฉ๐๐ญ๐จ๐๐ฎ๐ญ๐๐ง๐๐จ๐ฎ๐ฌ ๐ฌ๐ฒ๐ง๐๐ซ๐จ๐ฆ๐ is also known as ๐ฌ๐ฎ๐ฉ๐๐ซ๐๐ข๐๐ข๐๐ฅ ๐ง๐๐๐ซ๐จ๐ฅ๐ฒ๐ญ๐ข๐ ๐๐๐ซ๐ฆ๐๐ญ๐ข๐ญ๐ข๐ฌ. Putting both of these names together, you get a liver disease (hepato-) affecting the skin (cutaneous) that causes cell death (necrolytic).
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
This syndrome is most commonly seen in dogs!
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
The actual cause of hepatocutaneous syndrome is unknown, however it gets its name because almost 90% of patients have severe liver disease as well. So, it is thought that liver disease is a contributing factor to developing these skin lesions.
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
Hepatocutaneous syndrome attacks the ๐๐ฉ๐ข๐๐๐ซ๐ฆ๐๐ฅ (skin) cells, causing cell death. Affected areas of skin slough off easily, leaving crusty, bleeding areas that are extremely painful. The foot pads also become ๐ก๐ฒ๐ฉ๐๐ซ๐ค๐๐ซ๐๐ญ๐จ๐ญ๐ข๐, or crusted, due to the increased number of dead cells.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Diagnosis is made through skin biopsy! Hepatocutaneous syndrome produces a classic appearance under the microscope of a โred, white and blueโ epidermis. What the pathologist is really seeing is red from ๐ค๐๐ซ๐๐ญ๐ข๐ง (the protective layer of the skin), white from swollen and dying skin cells, and blue from ๐๐๐ฌ๐๐ฅ ๐๐๐ฅ๐ฅ๐ฌ, which are the reproducing cells that make new skin cells.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
Unfortunately, there is no specific treatment for this condition. Supportive care, such as increasing amino acids needed for skin health and treating underlying liver disease are helpful. Many patients are euthanized due to a poor prognosis.
๐๐ก๐จ๐ญ๐จ๐ฌ
1-2) Examples of hepatocutaneous syndrome on the skin!
3) A very sad looking liver from a dog with hepatocutaneous syndrome.
4) The classic โred, white and blueโ appearance under the microscope!
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 1. Sixth Edition.
Photos 1-4 ยฉ Noahโs Arkive contributor Schelling, Jakowski, Latimer and Rakich, Werner licensed under CC BY-SA 4.0.
