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Canine dermatitis on contacting grass leaf: A case series - Mason - 2023 - Veterinary Dermatology - Wiley Online Library
Canine dermatitis on contacting grass leaf: A case series
犬草叶接触性皮肤病：病例系列
Kenneth Mason| Merja Ruutu
翻译：王帆
Abstract
Background: Pruritus is a common clinical sign in dogs for which owners seek veterinary attention. Its diagnosis and treatment are often a source of frustration for the owner and veterinarian. Contact dermatitis is rarely considered, even when lesions are located only on the skin. This report describes the immediate reaction to grass leaf material after skin exposure, with similarities to human protein contact dermatitis.
Hypothesis/Objective: To describe the history, clinical findings, diagnostic methods, and characteristics of an undescribed canine pruritic dermatitis that is clinically distinct from canine atopic dermatitis and contact dermatitis.
Animals: Eighteen pet dogs living in Australia were referred for unresolved pruritic dermatitis.
Materials and Methods: Retrospective analysis of clinical records from patients with pruritic dermatitis after contacting grass leaves. Findings on skin testing, isolation, challenge, and description of skin lesions are described.
Results: Dogs had an inflammatory and pruritic dermatitis affecting the ventral chest, anterior-medial thighs and distal limb, areas that had been in contact with grass, which dogs instinctively avoided. Erythema and erythematous macules and papules were characteristic in the affected skin, inducing coat loss, and thickened pigmented skin. Isolating the dogs from grass resolved their clinical signs and pruritus returned within hours of contact with causative grass.
Conclusion and Clinical Importance: A literature review revealed that this canine dermatitis was similar to human protein contact dermatitis. The impact may be enormous for the treatment of dogs having this disease because the treatment path differs from the therapeutic options of common canine pruritic skin disorders, including the possibility of cure by avoidance.
摘要
背景: 瘙痒是犬中常见的临床症状，犬宠主为此寻求兽医帮助。其诊断和治疗常令犬主和兽医感到挫败。很少考虑接触性皮肤病，即使病变仅位于皮肤。本报告描述了皮肤暴露后对草叶材料的即时反应，与人类蛋白质接触性皮肤病相似。
假设/目的: 描述临床上与犬特应性皮肤病和接触性皮肤病不同的未识别的犬瘙痒性皮肤病，其病史、临床结果、诊断方法和特征。
动物: 18只宠物犬因未消退的瘙痒性皮肤病被转诊。
材料与方法: 本回顾性分析接触草叶后瘙痒性皮肤病病患。提供了涉及皮肤试验、隔离、激发和皮肤病变描述的临床记录。
结果: 在本研究中，犬出现炎症和瘙痒性皮肤病，波及腹侧胸部、大腿前内侧和远端肢体(与草接触的区域)，犬本能地避免了这些区域。皮肤发红和红色斑疹、丘疹是发病皮肤的特征，诱发被毛脱落，色素沉着，皮肤增厚。将犬从草中分离，其临 床症状消退，瘙痒在接触致病草数小时内复发。
结论和临床重要性: 文献综述显示该犬皮肤病与人蛋白接触性皮肤病相似。对患有该疾病的犬的治疗影响巨大，因为治疗路径与犬瘙痒性皮肤病的治疗选择不同，包括通过避开过敏原即可治愈。
INTRODUCTION
介绍
Pruritic dermatitis is a common canine condition presented to veterinarians. Pruritus may arise from various causes, including allergies, parasites, infections, sometimes neoplasia and other miscellaneous diseases. Canine atopic dermatitis (cAD) is one of the most diagnosed causes of pruritic dermatitis, and there are several recognised criteria for diagnosis.
瘙痒性皮肤病是一种犬常见的疾病。瘙痒可由多种病因引起，包括过敏、寄生虫、感染，有时也有肿瘤和其他各种疾病。犬特应性皮炎(cAD)是瘙痒性皮肤病最多诊断的病因之一，有几条公认的诊断标准。
Contact dermatitis is a less common cause of pruritus and is described as an inflammatory, noninfectious skin disease that occurs when relevant substances contact the skin. Human contact dermatitis is primarily an occupational skin disease with a reported annual incidence of 0.5–1.9 per 1000 workers. It can occur in all species, although it is considered rare in the dog.
接触性皮肤病是一种不太常见的引起瘙痒的病因，被描述为一种当相关物质接触皮肤时发生的炎性、非传染性皮肤病。人类接触性皮肤病主要是一种职业性皮肤病，据报道，每年发病率为每1000名工人0.5-1.9发病。虽然疾病可以发生在所有物种，但在犬中是罕见的。
Classic contact allergic dermatitis is a cell-mediated type IV immunopathological process caused by small chemicals called haptens (e.g. nickel, chromium and drugs such as neomycin) that is incapable of triggering an allergic reaction alone. Haptens need to bind to skin proteins for sensitisation to occur. The veterinary literature considers contact allergy as a disease with a cell-mediated immunopathogenesis.
经典的接触性过敏性皮肤病是一种细胞介导的IV型免疫病理过程，由称为半抗原的小化学物质(如镍、铬和新霉素等药物)引起，不能单独诱发过敏反应。半抗原需要与皮肤蛋白质结合才能致敏。兽医文献认为接触性过敏是一种细胞介导免疫发病机制的疾病。
Conversely, protein contact dermatitis (PCD) in humans was first reported by Hjorth in 1976 and referred to an allergic skin reaction triggered by proteins of either animal or insect origin. The allergens are proteolytic enzymes that induce urticarial and vesicular eruptions on contact with the skin.Immediate prick- or scratch-test results are positive in PCD, whereas patch test results are variable. Current evidence indicates immunoglobulin (Ig)E formation to a protein allergen is the pathomechanism.
相反，人类的蛋白质接触性皮肤病(PCD)是由Hjorth在1976年首次报道的，指的是由动物或昆虫来源的蛋白质引发的过敏性皮肤反应。过敏原是蛋白质水解酶，与皮肤接触会诱发荨麻疹和水疱。在PCD中，直接针刺或划痕试验结果是阳性，而贴片试验结果是多种多样的。目前的证据表明，针对蛋白质过敏原的免疫球蛋白(Ig)E结构是其发病机制。
Risk factors for developing PCD may include a history of atopy, chronic irritant dermatitis, and occupation or hobby involving exposure to protein allergens. PCD is associated with IgE-mediated reaction to proteins, particularly in certain occupations, such as bakers, veterinarians and meat workers. However, it is difficult to distinguish clinically from other causes of contact dermatitis.
发生PCD的危险因素可能病史包括特应性皮炎、慢性刺激性皮肤病、涉及接触蛋白质过敏原的职业或爱好。PCD与IgE介导的蛋白质反应有关，特别是在某些职业中，如面包师、兽医和肉食品员工。但是，临床上很难将接触性皮肤病与其他病因进行鉴别。
The current study describes 18 dogs with an atopic-like disease that resembles PCD reported in humans and called canine grass dermatitis (CGD) in this paper. This report summarises the anamnesis, clinical findings, and skin allergen tests of 18 dogs with pruritus and inflamed skin associated with the contact to grass leaves. The authors believe this may be a new and unreported skin disease of dogs.
目前的研究描述了18只异位样皮炎患犬，这种疾病类似于人类的PCD，在本文中称为犬草叶皮肤病(CGD)。本报告总结了18只因接触草叶而出现皮肤瘙痒和炎症的犬的既往史、临床表现和皮肤过敏原试验。作者认为这可能是一种新的未报道的犬皮肤病。
MATERIALS AND METHODS
材料和方法
Source of data
数据来源
The clinical records of the first author's veterinary dermatological service were searched for details of dogs diagnosed with contact allergy to grass leaf from 2001 to 2019. Patients were selected after considering all diagnostic alternatives. This is a retrospective study and owner consent thus was not required. Owners gave their consent to use the photos for educational purposes.
从第一作者的兽医皮肤科临床的临床记录中，检索了2001年至2019年被诊断为草叶接触性过敏的犬的详细信息。患犬是在考虑了所有的诊断方案后选择的。这是一项回顾性研究，因此不需要宠主同意。宠主同意将这些照片用于教育目的。
Diagnostic criteria
诊断性标准
All cases had to fulfil the following diagnostic criteria:
所有病例必须符合以下诊断标准:
1. An inflammatory skin disease that is pruritic.
2. Clinical signs of atopic dermatitis (AD) or atopic-like dermatitis, with intradermal skin test (IDT) weak or negative for common aeroallergens.
3. Negative cytological results for pathogen overgrowth on skin and if available, histopathological results inconsistent with cAD.
4. Resolution of clinical signs and pruritus (70%–100%) after bathing with non-medicated shampoo (to remove allergens) and isolation from any plant material (with access to aeroallergens permitted) for ≤48h.
5. At challenge (re-exposure) via contact to grass, reappearance of all clinical signs within 24h (generally within few hours).
6. Immediate (within 20min) positive crude scratch test (cST) to grass from the garden or place associated with signs.
1.瘙痒性炎性皮肤疾病
2.特应性皮炎(AD)或异位样皮炎的临床表现，皮内皮试(IDT)常见空气过敏原弱或阴性。
3.皮肤细胞学结果微生物增殖为阴性，如果有，组织病理学结果与cAD一致。
4.使用非药物香波洗澡(清除过敏原)并与任何植物隔离(允许接触空气过敏原)≤48小时后，临床症状和瘙痒消失(70%-100%)。
5. 接触草后，24小时内(一般在几小时内)再次出现所有临床症状。
6. 对花园或有症状地方的草进行粗提取物划痕试验(cST)立即(20分钟内)阳性。
Skin testing
皮肤测试
Two skin allergen tests were performed on each dog, as follows:
对每只犬进行两次皮肤过敏原测试，具体如下:
1. A cST using a crude extract from plants the animal was exposed to and could physically contact. Initially, the senior author visited the house gardens to collect plant samples. Later, the pet owners were advised to present garden grasses that the dog avoided or was in contact with. These were washed in tap water, blotted dry with a new paper hand towel, and then macerated in cold phenol saline (Greer Laboratories) at approximately 1:20 using a mortar and pestle (Figure S1).
1. 一种使用动物接触过并能接触到的植物粗提取物的cST。最初，资深作者参观了房屋花园，收集植物样本。随后，研究人员建议宠物宠主拿出犬避免接触或接触的花园草。在自来水中清洗，用新的纸巾吸干，然后用研钵和杵在大约1:20的冷苯酚盐水(Greer实验室)中浸泡(图S1)。
2. An IDT containing environmental allergens (Greer) with a panel of pollens and environmental allergens was prepared every 14days and stored and applied as per the manufacturer's instructions. The allergens used were common in the local environment. Each dog was sedated using medetomidine (30μg/kg intravenously or intramuscularly) and supplemented with mask inhalation of isoflurane if required for the test.
2. 使用一组花粉环境过敏原(Greer)进行IDT，环境过敏原每14天制备一次，并按照制造商的说明存储和应用。所使用的过敏原在当地环境中很常见。每只犬均给予美托咪定(30μg/kg静脉注射或肌注)镇静，根据试验需要面罩吸入异氟醚维持。
After IDT reading, the cST proceeded with plants and grass leaf extract that had soaked undisturbed for 1 h. The epidermis was scratched with a 25G needle sufficiently gently to avoid bleeding and the plant extract, phenol saline, or histamine was applied on individual scratches. The cST results were recorded at 20min and a raised line on skin covered with material was considered a positive result. Owners then were given a test map identifying the IDT and cST sites and asked to photograph and record any visible reaction for the next 2days. A Queensland Government botanist identified the plants used in the scratch test collected during house visits. Examples pressed in newspaper and laminated then were used to help identify plant material provided by pet owners.
IDT读取后，进行cST，使用未受干扰浸泡1小时的植物和草叶提取物。用25G针足够轻柔地划伤表皮以避免出血，并在单个划伤处涂抹植物提取物、苯酚盐水或组胺。在20min记录cST结果，被材料覆盖的皮肤上有凸起的线被认为是阳性结果。然后给宠主一张识别IDT和cST位点的测试地图，并要求他们在接下来的两天里拍摄和记录任何可见的反应。昆士兰政府的一名植物学家鉴定了在家访期间收集的划痕测试中使用的植物。样本被压在报纸上，然后被用来帮助识别宠物宠主提供的植物材料。
Histopathological evaluation
组织病理学评估
Tissue was taken by biopsy from Case 7, fixed in 10% buffered formalin, processed routinely, and embedded in wax block from which 5μm sections were cut and stained in haematoxylin & eosin.
从病例7中取组织活检，在10%缓冲福尔马林中固定，常规处理，并嵌入蜡块，从蜡块中切割5μm切片，用苏木精和伊红染色。
RESULTS
结果
A total of 18 dogs fulfilled the diagnostic criteria for grass dermatitis. They were of various breeds, sexes (8 male, 10 female), and most were short-haired (Table 1). The average age of onset for clinical signs was 9.4 months, and the average age at presentation to a clinic was 3years. Affected dogs exhibited constant scratching, licking and chewing of the feet and head area (lesional area). Dogs living outside and confined to a grassy garden commonly had more severe lesions. Most (11 of 18) of the owners had noticed dogs avoiding certain lawn areas, and two dogs showed improvements when not in their usual home environment. Clinical signs were not seasonally correlated.
共有18只犬符合草叶皮肤病的诊断标准。它们的品种、性别各不相同(雄性8只，雌性10只)，大多数为短毛(表1)。临床症状的平均发病年龄为9.4月龄，平均就诊年龄为3岁。患犬表现出持续抓挠、舔舐和啃咬足部和头部区域(病变区域)。生活在室外和局限在草地花园的犬通常有更严重的病变。大多数(18个中的11个)宠主注意到犬会避开某些草坪区域，有两只犬在不属于它们通常的家庭环境时表现出了改善。临床症状无季节相关性。
All dogs had a careful assessment to rule out any other diagnosis, including ectoparasites, food allergies, flea allergy dermatitis (FAD), cAD and irritant dermatitis. Lesions predominantly occurred on the skin that touched the ground, such as the ventral chest, abdomen, anterior-medial tarsus, and carpus. A ‘waterline’ effect frequently occurs (Figure 1) on slab-sided dogs, where ventral erythema occurs on skin that contacts the grass when the dog lies down. Primary lesions were erythema, macules and papules with secondary alopecia, hyperpigmentation and lichenification. The skin lesions' distribution was on the ventral abdomen, ventral chest and anterior-medial thigh (Figure 2). Some dogs had lesions in the interdigital skin folds that had been in contact with the grass, yet the protected groove showed no clinical signs (Figure 3a). Lesions occurred at the posterior carpus, tarsus and lateral distal hind limb (Figure 3). The facial area lesions concentrated on the muzzle, posterior aspect of the erect ear and concave hairless side of the non-erect ear occurring on dogs kept outside that could not avoid grass (Figure 4).
所有的犬都进行了仔细的评估，以排除任何其他诊断，包括体外寄生虫、食物过敏、跳蚤过敏性皮肤病(FAD)、cAD和刺激性皮肤病。病变主要发生在接触地面的皮肤上，如胸部腹侧、腹部、跗骨前内侧和腕骨。“水平面”效应经常出现在侧躺的犬上(图1)，当犬躺下时，腹侧皮肤发红出现在接触草的皮肤上。原发病变为皮肤发红、斑点和丘疹，继发为脱毛、色素沉着和苔藓化。皮肤病变分布在腹侧、胸侧和大腿前内侧(图2)。部分犬与草接触的指间皮肤皱褶有皮肤病变，但受保护的缝隙没有临床症状(图3a)。病变发生在腕骨、跗骨后部和后肢外侧远端(图3)。面部病变集中在口鼻、直立耳后部和非直立耳无毛凹侧，发生在无法避开草的室外犬(图4)。
The IDT was weak or negative in these dogs for common aeroallergens (pollens of trees, grasses and weeds), yet frequently positive to house dust mites (HDM). The scratch test using plants from the dog's environment showed positive and negative results for various plants. Dogs reacted primarily to plants in their immediate environment, mainly carpet grass (Axonopus compressus), Kikuyu (Pennisetum clandestinum), paspalum (Paspalum notatum) and different plants in the family Commelinaceae, commonly called wandering trad or spiderwort (Tradescantia zebrina, Tradescantia pallida, Tradescantia spathacea, Callisia fragrans and Callisia repens) (Table S1). The reactions to the cST were positive within 20min, and most subsided simultaneously as IDT reactions. However, owners reported an occasional persistence at 24–36h and none at 48h.
这些犬对常见空气过敏原(树粉、草粉和杂草粉)的IDT呈弱或阴性，但对室内尘螨(HDM)的IDT通常呈阳性。使用犬所处环境中的植物进行的抓痕测试显示，各种植物对犬的影响有阳性也有阴性。犬主要对周围环境中的植物有即使反应，主要是地毯草(大叶油草)、基库尤草(狼尾草)、百喜草(巴哈雀稗)和鸭跖草科的不同植物，通常被称为流浪草或蜘蛛草(斑竹、白竹、肉苁蓉、香萼藻和重萼藻)(表S1)。cST反应在20min内呈阳性，多数与IDT反应同时消退。然而，宠主报告说，在24-36小时内偶尔会持续，而在48小时内则没有持续。
After the initial in-clinic assessment, dogs returned home with instructions to owners to bathe dogs with a nonmedicated shampoo, isolate them from any garden plants and retain access to aeroallergens and insects. The isolation area commonly was the house and or veranda and various cemented or tiled enclosures. Improvement during isolation was the final confirmation of contact dermatitis. The pruritus and erythema resolved within 12h, and papules and macules within 24–36h.
在首诊评估后，犬回家时，会告诉宠主用非药物香波给犬洗澡，将它们与所有花园植物隔离，可以接触空气过敏原和昆虫。隔离区域通常是房子和或阳台以及各种水泥或瓷砖的围墙。通过隔离期间的改善，最终确认是接触性皮肤病。瘙痒和皮肤发红在12h内消退，丘疹和斑点在24-36h内消退。
Isolated dogs were challenged when allowed back on grass wet with dew (in the morning). All the dogs flared within the same day, most in a few hours. The exact time of challenge to return of pruritus was not assessed in most cases because of pet owners being at work or fulfilling other commitments; however, two owners reported pruritus return after 2 and 6 h, respectively.
被隔离的犬在被允许回到沾有露水的草地上(在早上)时接受激发。所有的犬都在同一天突然发病，大多数是在几个小时内发病的。在大多数病例中，由于宠物宠主在工作或做其他事情，所以没有评估瘙痒开始的确切时间;然而，有两名宠主分别在2和6小时后发现瘙痒复发。
A 7-month-old husky (Case 15) showed lesions in typical areas on presentation and after confinement for several months without medication on a fenced tiled pool area revealed dramatic improvement (Figure S2).
一只7月龄的哈士奇(病例15)在出现症状时出现了典型部位的病变，在没有药物治疗的情况下，将其关在有围栏的瓷砖泳池区域几个月后，病情有了显著改善(图S2)。
Histopathological results revealed intraepidermal pustules with eosinophils in spongiotic epidermal hyperplasia and lymphocyte exocytosis. The superficial dermis was diffusely infiltrated with a mixture of eosinophils and lymphocytes and centred on vessels (Figure 5).
组织病理学结果显示表皮内脓疱伴嗜酸性粒细胞，表皮海绵状水肿增生及淋巴细胞外排。真皮浅层弥散性嗜酸性粒细胞和淋巴细胞的混合浸润，并以血管为中心(图5)。
DISCUSSION
讨论
This study revealed 18 dogs with intense pruritus and erythematous papular and macular lesions found in dogs with AD or contact dermatitis. Pruritus and erythematous lesions resolved while exposure to aeroallergens and HDM and excluded grass. When challenged by returning to the wet grass, there was a consistent recurrence of pruritus and, soon after, erythematous lesions. Although the exact timing for the reappearance of clinical signs was hard to evaluate since most owners did not stay with the dog, the pruritus and erythema had recurred by 12h.
这项研究揭示了18只伴有强烈瘙痒和皮肤发红丘疹和斑点病变的AD患犬或接触性皮肤病患犬。暴露于空气过敏原和HDM并避开草后，瘙痒和皮肤发红病变得到缓解。当回到潮湿的草地激发时，瘙痒持续复发，不久之后出现皮肤发红病变。虽然临床症状再次出现的确切时间很难评估，因为大多数宠主都没有和犬在一起，但瘙痒和皮肤发红在前12小时复发。
A search of the literature revealed that the disease in dogs resembles protein contact dermatitis in humans. The pathogenesis of human protein contact dermatitis is still primarily unknown; however, it is suspected to involve type I and type IV hypersensitivity reactions or late-type I reactions.Experimental models of protein contact dermatitis show IgE and eosinophil involvement.
对文献的研究表明，犬的这种疾病类似于人类的蛋白质接触性皮肤病。人蛋白质接触性皮肤病的发病机制尚不清楚;但怀疑涉及I型、IV型超敏反应或迟发I型反应。蛋白质接触性皮肤病的实验模型显示涉及IgE和嗜酸性粒细胞。
The dogs responded positively to cST and isolation from the garden grass and flared quickly after re-challenging. This, and the eosinophils in the histological findings, was supportive of an IgE-mediated pathology, as in human PCD. One dog developed anaphylaxis after the cST, identical to the case of anaphylaxis against the garden plant material, Callisia fragrans recorded previously.
犬对cST有阳性反应和花园草地隔离有效，在再激发后迅速发病。这一点，以及组织学发现的嗜酸性粒细胞，支持IgE介导的病理变化，如人类PCD。一只犬在cST后出现过敏反应，与之前记录的对花园植物-桂花锦竹草过敏反应的情况相同。
Many pet owners spontaneously commented that their pet hated getting their feet wet or avoided wet grass. Subsequently, avoiding damp grass or getting wet feet became a routine question on all pruritic dermatitis questionnaires. This unusual phobia of avoiding wet grass was positively related to contact with the allergic grass.
许多宠主自发地评论说，他们的宠物讨厌把脚弄湿，或者避开湿草。随后，“是否有避开潮湿的草地或避免脚变湿”成为所有瘙痒性皮肤病问卷的常规问题。这种不寻常的对湿草的恐惧与草接触性过敏症正相关。
Plant allergens often are in a plant's pollen. This was not the case in the 18 canine cases described here since dogs had access to aeroallergens when isolated from the grass. The allergen was suspected in the leaf and became available to the dog's skin when wet. The human literature reports several cases that show immediate contact reactions against plant leaf material (including grass leaf) and the blood tests show IgE against the offending material. There also are documented human cases of immediate reactions against grass leaf, yet IgE was not assessed in those cases.
植物过敏原通常存在于植物的花粉中。在这里描述的18只犬的病例中，情况并非如此，因为从草中分离出来的犬可以接触到空气过敏原。过敏原被怀疑存在于树叶中，当树叶湿润时，过敏原就会进入犬的皮肤。人类文献报告了几个病例，显示对植物叶材料(包括草叶)的直接接触反应，血液测试显示对有害材料的IgE。也有文献记载的人类对草叶产生即时反应的病例，但在这些病例中没有评估IgE。
The cST used in these dogs was helpful; however, the concentration of the allergen accessing the skin was uncontrolled, making the interpretation difficult. This is a limitation in this retrospective study, as is the owner-produced grass samples being insufficient for identification. However, dogs showed no reactions at the cST site at 48h, indicating that the pathology was unlikely type IV in these cases. A further limitation in the study is that in most cases, it was left to the owners' discretion to assess redness on the skin, although a photograph also was provided.
在这些犬上使用的cST是有用的;然而，接触皮肤的过敏原的浓度是不受控制的，这使得解释变得困难。这是这项回顾性研究的一个局限性，因为宠主提供的草样本不足以用于识别。然而，48小时后，犬在cST部位没有任何反应，这表明这些病例的病理不太可能是IV型。这项研究的另一个局限性是，在大多数病例中，虽然由宠主自行判断皮肤上的红肿程度，但研究人员也提供了照片。
Dogs in this study developed pruritus and lesions in the areas that were in contact with the grass. As shown, the axillae and the feet-deep furrows were clear of erythema, indicating that the lesions were caused by contact with an allergen. This pattern was unlike pollen allergies where erythema also occurs in these crevices. The histological results were different to that of dog with cAD, which typically is mononuclear and perivascular centred. A ventral papular lesion biopsy revealed large epidermal eosinophilic pustules and diffuse dermal inflammation dominated by eosinophils perivascularly and within the vascular wall. Similar histopathological findings have been published on the biopsy of skin treated with plant leaf material. Canine atopy histological evaluation often is complicated by secondary infection; however, the findings without secondary infections are mainly lymphocytes, rarely eosinophils. More biopsy case material will be needed to confirm the findings from this single example.
在这项研究中，犬在与草接触的区域出现瘙痒和病变。如图所示，腋窝和足深处皱褶处没有皮肤发红，表明病变是由接触过敏原引起的。这种模式不同于花粉过敏，花粉过敏也会在这些缝隙中出现皮肤发红。组织学结果与cAD患犬的典型的以单个核和血管周围为主不同。腹侧丘疹性病变活检显示大的表皮嗜酸性脓疱，弥散性以嗜酸性粒细胞为主的真皮炎症，分布于血管周围和血管壁内。类似的组织病理学发现已发表在用植物叶片材料处理的皮肤活检上。犬特应性皮炎组织学评价常伴有继发感染;但结果为无继发感染的主要以淋巴细胞，罕见嗜酸性粒细胞。更多的活检病例材料将需要确认从这一个单一的例子的发现。
Grasses have hairs that irritate and may cause dermatitis. It could be argued that these can be a cause of an irritant dermatitis or may be the site of a potential allergen that caused the dermatitis in the 18 dogs of this report. However, cST reaction revealed an immediate type of allergic reaction and in some cases a late reaction within 24h that resolved by 48h, and anaphylaxis in one of 18 cases, all of which is consistent with an immediate type immune IgE allergy.
草毛会刺激皮肤，可能会引起皮肤病。可以认为，这些可能是刺激性皮肤病的病因，或者可能是导致本报告中18只犬皮肤病的潜在过敏原的病因。然而，cST反应显示立即型过敏反应，在一些病例中，24小时内的迟发反应在48小时前消失，18例中有一例出现过敏反应，所有这些都与立即型免疫IgE过敏一致。
The limitations of this study are those inherent in the human aspects of clinical medicine. That is bias, memory and clinical acumen. The accuracy and reliability of plant identification have limitations related to pet owner selection and sample condition, which often is insufficient for accurate identification. Common names usually cover several species. The 18 cases and thus sample size was limited for subgroup analyses, such as predisposition of the breed, age and coat length. The pathophysiological proposals in the discussion require a laboratory-based investigation, including the IgE reactivity to grass leaf material, for further verification. This study included dogs with the broadest and most complete data, yet there were many others where, for example, histopathological findings supported the single case here. To confirm these findings, more studies are needed that would include a complete set of assays including recording challenge time, IgE reactivity against plant leaf material, and biopsies.
本研究的局限性在于临床医学的人性方面。那就是偏见，记忆和临床敏锐。植物鉴定的准确性和可靠性受到宠主选择和样品条件的限制，往往不足以准确鉴定。常见的名字通常包括几个物种。这18个病例和样本量被限制用于亚组分析，如品种的易感性、年龄和被毛长度。讨论中的病理生理学建议需要一个基于实验室的调查，包括IgE对草叶材料的反应性，以进一步验证。这项研究包括了拥有最广泛和最完整数据的犬，但还有许多其他的，例如，组织病理学结果支持这里的单一病例。为了证实这些发现，还需要进行更多的研究，包括记录激发时间、IgE对植物叶片材料的反应性和活组织检查。
To conclude, this report describes a novel disease in dogs caused by an allergen in grass leaf and not grass pollen. This novel canine dermatitis pathogenesis resembles human protein contact dermatitis. Reports of PCD in dogs presented to veterinarians has not been published previously. The 18 dogs herein have a negative to irrelevant IDT, and lesions include erythema, macules, papules, secondary alopecia, hyperpigmentation and lichenification. The most striking difference to cAD is the distinct occurrence of lesions in areas that are in contact with the ground. Patients have positive immediate cST results against common garden grasses, when bathed and isolated from garden grass, show quick resolution of clinical signs, and flare when challenged back on the grass. Affected dogs show reluctance to walk on the grass when wet. Further studies are needed to confirm this finding and investigate the pathogenesis in greater detail.
总之，本报告描述了一种由草叶过敏原而不是草粉引起的犬的新疾病。这种新型犬皮肤病的发病机制类似于人蛋白质接触性皮肤病。兽医所见的犬类PCD的报告以前从未发表过。这18只犬的IDT均为阴性，病变包括皮肤发红、斑点、丘疹、继发性脱毛、色素沉着和苔藓化。与cAD最大区别是在与地面接触的区域明显发生病变。患犬对普通花园草有直接阳性的cST结果，当洗澡并避开花园草时，临床症状迅速消退，当再次接触草地时，会发作。患犬在湿的时候不愿意在草地上走。需要进一步的研究来证实这一发现，并更详细地研究发病机制。
FIGURE 1 Lesion distribution in dogs with contact dermatitis to grass. (a,b) Waterline effect at lateral slab chest; barrel-chested dogs have a patch of lesions where the chest contacts the grass (c,d)
图1草叶接触性皮肤病患犬的皮肤病变分布。(a,b)侧胸水平面效应;桶状胸犬胸部与草叶接触处有一小块病变(c,d)
FIGURE 2 Primary lesions of erythema, macules, papules, (b, c, d) and secondary alopecia (a,c,d) hyperpigmentation and lichenification (a). Distribution typically is on the ventral abdomen, ventral chest and anterior-medial thigh
图2原发病变皮肤发红、斑点、丘疹(b, c,d)和继发性脱毛(a,c,d)色素沉着和苔藓化(a)。典型分布在腹部腹侧、胸部腹侧和大腿前-内侧。
FIGURE 3 Ventral paw interdigital skin fold touching grass is affected, and groove protected from grass shows no lesions or erythema (a). Classical posterior carpus (b) and tarsus (d) lesions are shown in areas contacting grass. Lateral distal hind limb (c) also is affected.
图3接触草的掌腹指间皮肤皱褶患病，不接触草的缝隙部未见病变或皮肤发红(a)。接触草的区域显示经典腕骨(b)和跗骨(d)后部病变。后肢外侧远端(c)也患病。
FIGURE 4 Lesions often are distributed in ears and muzzle. Photos show most common sites of lesions at ventral chin muzzle (a), muzzle (b), posterior of erect ear (c) and concave hairless side of the non-erect ear (d). These lesions tend to be on dogs that cannot avoid the grass
图4病变多分布于耳部和口周部。照片显示最常见的病变部位在下巴腹侧口周(a)，口周(b)，直立耳后部(c)和非直立耳无毛的凹侧(d)。这些病变往往发生在无法避开草地的犬上。
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发表于 2023-4-13 14:53:34
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