Abstract：
A 10-year-old, spayed female Shih Tzu dog presented with a history of progressive erythema and multiple crusts developing 85 days previously. The dog had been diagnosed with hyperadrenocorticism (HAC) 55 days prior to presentation and was treated with oral trilostane (2.86 mg/kg, once daily) that was discontinued due to a poor response. In addition to generalised alopecia, erythematous plaques and crusts were noted on the trunk, head and footpads. Lesional impression smears revealed numerous acantholytic cells and non-degenerated neutrophils. Histopathological findings demonstrated subcorneal pustules with acantholytic cells and intact neutrophils. On the basis of these findings, we diagnosed pemphigus foliaceus (PF) with concurrent HAC. We wished to avoid glucocorticoids and, therefore, prescribed oral, once-daily azathioprine (2 mg/kg), modified cyclosporine (7 mg/kg) and ketoconazole (5 mg/kg). By day 71 post-treatment, the erythematous crusts had almost disappeared and the alopecia had improved considerably. However, by the subsequent follow-up examination on day 99, the clinical signs had reappeared due to the tapering of cyclosporine. To the best of our knowledge, this is the first case report describing concurrent PF and HAC in a dog. Combination therapy with azathioprine, modified cyclosporine and ketoconazole was effective, and should be considered for dogs diagnosed with concurrent autoimmune diseases and HAC.
摘要：
一个10岁的孩子,Spyed雌性ShihTzu犬有进行性红斑病史，并且在85天之前发展了多个结皮。该狗在出现前55天被诊断出患有高肾上腺皮质（HAC），并口服三氯甾烷（2.86mg/kg，每天一次)，由于反应不佳而停产。除了广泛性脱发,躯干上有红斑和结皮，头和脚垫。病变印模涂片显示大量棘皮溶解细胞和未退化的中性粒细胞。组织病理学发现显示角膜下脓疱具有棘皮溶解细胞和完整的中性粒细胞。根据这些发现,我们诊断为天疱疮（PF）并发HAC。我们希望避免糖皮质激素，因此,开处方口服,每日一次硫唑嘌呤（2mg/kg），环孢菌素（7mg/kg）和酮康唑（5mg/kg）。治疗后第71天，红斑结皮几乎消失，脱发有很大改善。然而,通过随后在第99天的随访检查,由于环孢素逐渐减少,临床症状再次出现.据我们所知,这是首例描述狗并发PF和HAC的病例报告.硫唑嘌呤联合治疗，环孢菌素和酮康唑是有效的，对于诊断为并发自身免疫性疾病和HAC的狗，应考虑。
