A case of presumed autoimmune subepidermal blistering dermatosis treated with oclacitinib.

BACKGROUND Autoimmune subepidermal blistering dermatoses (ASBD) are a group of severe autoimmune dermatoses rarely described in dogs. Their treatment usually necessitates the long term use of medications potentially associated with adverse effects. In humans, Janus Kinase (JAK) inhibitors have been demonstrated to be of value in some cases of autoimmune skin disease. HYPOTHESIS/OBJECTIVES To evaluate oral oclacitinib, a JAK-1 predominant inhibitor, in one case of ASBD in a dog. CASE REPORT A 5-year-old German shepherd cross-bred dog was presented with an acute onset of ulcerative and blistering skin lesions on the face, oral cavity, lateral trunk and limbs. Associated systemic signs were not seen. A clinical diagnosis of ASBD was supported by the finding of subepidermal clefts and visualization of the epidermal basement membrane zone at the bottom of the clefts on histopathological examination. Treatment was initiated with prednisolone at 1.2 mg/kg twice daily. Because of severe adverse effects and relapse, when the prednisolone dose was reduced, oclacitinib therapy was administered at 0.5 mg/kg twice a day. A complete resolution of clinical signs was noted after one month and no relapse was observed after twelve months of treatment. No adverse effects were reported. CONCLUSION The use of oclacitinib may be useful for the treatment of some autoimmune skin diseases in dogs. Further controlled studies are needed to confirm our findings.

[1]  T. Olivry,et al.  Mucous membrane pemphigoid in dogs: a retrospective study of 16 new cases. , 2016, Veterinary dermatology.

[2]  F. Antonicelli,et al.  Integrating longitudinal serum IL-17 and IL-23 follow-up, along with autoantibodies variation, contributes to predict bullous pemphigoid outcome , 2015, Scientific Reports.

[3]  A. Christiano,et al.  Reversal of Alopecia Areata Following Treatment With the JAK1/2 Inhibitor Baricitinib , 2015, EBioMedicine.

[4]  P. Stein,et al.  Inhibition of TYK2 and JAK1 Ameliorates Imiquimod-Induced Psoriasis-like Dermatitis by Inhibiting IL-22 and the IL-23/IL-17 Axis , 2014, The Journal of Immunology.

[5]  T. Olivry An autoimmune subepidermal blistering skin disease in a dog? The odds are that it is not bullous pemphigoid. , 2014, Veterinary dermatology.

[6]  W. Nishie Update on the pathogenesis of bullous pemphigoid: an autoantibody-mediated blistering disease targeting collagen XVII. , 2014, Journal of dermatological science.

[7]  Massimo Gadina,et al.  Jakpot! New small molecules in autoimmune and inflammatory diseases , 2014, Experimental dermatology.

[8]  M. Gadina Janus kinases: an ideal target for the treatment of autoimmune diseases. , 2013, The journal of investigative dermatology. Symposium proceedings.

[9]  J. O’Shea,et al.  Janus kinase inhibitors in autoimmune diseases , 2013, Annals of the rheumatic diseases.

[10]  D. Zillikens,et al.  Pemphigoid diseases: Pathogenesis, diagnosis, and treatment , 2012, Autoimmunity.

[11]  J. Fridman,et al.  Preclinical evaluation of local JAK1 and JAK2 inhibition in cutaneous inflammation. , 2011, The Journal of investigative dermatology.

[12]  Mei Chen,et al.  Clinical and immunological heterogeneity of canine subepidermal blistering dermatoses with anti-laminin-332 (laminin-5) auto-antibodies. , 2010, Veterinary dermatology.

[13]  Naoko Kamio,et al.  IgG from patients with bullous pemphigoid depletes cultured keratinocytes of the 180-kDa bullous pemphigoid antigen (type XVII collagen) and weakens cell attachment. , 2009, The Journal of investigative dermatology.

[14]  E. Olasz,et al.  Bullous pemphigoid and related subepidermal autoimmune blistering diseases. , 2008, Current directions in autoimmunity.

[15]  T. Olivry Natural Bullous Pemphigoid in Companion Animals , 2003 .

[16]  T. Olivry,et al.  Isotype determination of circulating autoantibodies in canine autoimmune subepidermal blistering dermatoses. , 2003, Veterinary dermatology.

[17]  T. Olivry,et al.  Autoimmune blistering dermatoses in domestic animals. , 2001, Clinics in dermatology.

[18]  J. C. Jones,et al.  Canine Bullous Pemphigoid (BP): Identification of the 180-kd Canine BP Antigen by Circulating Autoantibodies , 1995, Veterinary pathology.