Clinical, Immunological and Pathological Characteristics of Ischemic Dermatopathy in Dogs with Leishmaniosis

Cutaneous lesions suggestive of vasculitis and/or ischemic dermatopathy (ID) are anecdotally reported in canine leishmaniosis, and the clinicopathological features of these conditions have not been fully characterized. The objective of this case series was to describe six dogs with leishmaniosis and ID. In 5/6 dogs, leishmaniosis was diagnosed at the time of ID diagnosis, whereas in 1/6 dogs, ID developed during the first month of anti-Leishmania conventional treatment. One each of greyhound, Chihuahua, whippet, American bully, hound and mixed breeds were represented, and the median age at presentation was 6 years [2-8]. All patients presented high or very high levels of circulating anti-Leishmania infantum antibodies. The cutaneous lesions were multifocal alopecia with atrophic skin with hyper- or hypopigmentation (6/6), ulcers located on the extremities and trunk (3/6) and onychodystrophy (2/6). Histologically, ID was confirmed by the presence of follicular atrophy (faded follicles) (6/6), perivascular or interstitial lymphoplasmacytic dermatitis or panniculitis (6/6), collagen smudging (3/6), dermal fibrosis (3/6), lymphocytic interface dermatitis (3/6) and ulceration (3/6). Vasculopathy was observed in the superficial and mid-vascular plexuses in 4/6 dogs and characterized by the combination of some of the following lesions: vasocongestion, hemorrhagic foci, mild hyaline mural degeneration, thrombi and fragmented degenerating nuclear debris of neutrophils in the vascular wall. Moreover, myositis was observed in 1/6 cases. Leishmania-specific immunohistochemistry was positive in the skin of 4/6 cases. Leishmaniosis might be considered an underlying cause of ID in dogs. However, the immune mechanisms and pathogenesis need to be elucidated.