Demodex injai associated with Anaplasma spp and epiteliotrophic lymphoma in a 9 year old male Akita

Case report

unnamed

Dr Alberto M Cordero

A. MARTIN CORDERO
vetderm25@gmail.com

*VETDERM: Dermatologia Veterinaria Especializada, Guadalajara, Mexico
Assistant professor Department of Veterinary Medicine, Centro Universitario de Ciencias Biologicas y Agropecuarias, University of Guadalajara; Guadalajara, Jalisco, Mexico

A male non neutered 9 year-old Akita was presented with alopecic focal crusty lesions on rear and front limbs. Hemorrhagic lesions were observed on the front limb and history of tick infestation was provided by the owner. Ulcerative and nodular lesions were present on the right lateral aspect of the face. Skin scraping revealed presence of Demodex injai. .2014-01-28 19.20.56 ELISA rapid testing IDEXX 4DX was performed to confirm tick borne disease revealing positivity to Anaplasma spp. 2014-01-28 19.21.102014-01-28 19.21.302014-01-28 19.22.302014-01-28 19.14.152014-01-28 19.14.02Skin biopsies were taken from the face and abdomen revealing large atypical lymphocytes with epitheliotrophism consistent with epitheliotrophic lymphoma. The patient was presented one month later with pleural effusion, euthanasia was performed.

A male non-neutered 9 year old Akita was presented with history of focal crusty lesions. Due to his geographic origin from the North of Mexico close to the border with the United States and comments from the owner about tick infestation an ELISA SNAP 4dx plus test (Idexx) was performed.

SNAP test was positive to Anaplasma spp.

CBC showed no abnormalities.

Cutaneous lesions observed include, crusty and erythematous lesions in the abdominal regions, crusts, erosion and ulceration in the muzzle and petechial and ecchymosis in the front left limb.

A deep skin scraping was performed revealing the presence of long body Demodex compatible with Demodex injai.

Treatment with weekly Doramectin at 0.5mg/kg was started in conjunction with Doxycycline at 10mg/kg per day.

After 5 weeks of treatment owner reported depression and decrease of food ingestion, also, the appearance of new lesions in the muzzle region. Physical examination show nodular and plaque erythematous formations in the face and ventral region.

Cytology by fine needle aspiration was performed revealing atypical lymphocites characterized by cluster aggrupation, anisocytosis, and prominent nucleoli.2014-03-10 20.04.042014-03-10 20.04.082014-03-10 20.04.122014-03-10 20.04.152014-03-10 20.04.32

Three biopsies were taken using a 6mm punch biopsy and sent to dermatopathological examination. Results of the biopsy showed large atypical lymphocytes with epitheliotrophism consistent with epitheliotrophic lymphoma.

2 weeks later the patient was presented with pleural effusion and respiratory distress. Euthanasia was performed by owner request.IMG_1567

Conclusions

Demodectic mange may appear in a juvenile or adult onset presentation, as well as generalized or localized form. Patients with adult presentation should be screened in search for underlying conditions. In most cases underlying conditions will not be found. In order to control the disease, primary cause should be treated and corrected1.

Correct approach to dermatological conditions include a well-detailed clinical history and diagnostic test according to lesions found. We should be aware of perform all the diagnostic dermatological test we need, du to the fact, there are several dermatosis associated with secondary factors or associated conditions.

 

1.- Mueller, R. S., Bensignor, E., Ferrer, L., Holm, B., Lemarie, S., Paradis, M., & Shipstone, M. A. (2012). Treatment of demodicosis in dogs: 2011 clinical practice guidelines. Veterinary Dermatology, 23(2), 86–e21

Luba Gancheva