Subepidermal bullous dermatosis due to topical corticosteroid therapy in dogs

Six adult dogs were presented with an unusual bullous dermatosis affecting the glabrous skin of the ventral abdomen and medial thighs. Clinically, flaccid bullae were accompanied by erythema, ulceration, haemorrhage and hyperpigmentation in four of six dogs; the remaining two dogs had thin skin without grossly apparent bullae. Histologically, subepidermal bullae and clefting, vascular proliferation and dilatation (phlebectasia), and alteration in the density and staining of superficial dermal collagen were seen in all dogs. In all cases, corticosteroid-containing topical products had been applied to the affected areas prior to the development of the dermatosis; skin lesions resolved when topical corticosteroids were withdrawn. Follow-up biopsy of three dogs showed resolution of the previously abnormal collagen and subepidermal clefting. Residual lesions included phlebectasia, comedones and hyperpigmentation. The authors postulate that subepidermal clefting was due to local, corticosteroid-induced skin fragility. This is the first report, to our knowledge, of bullous skin disease in dogs resulting from topical corticosteroid therapy.