Superficial Necrolytic Dermatitis (Hepatocutaneous Syndrome) in a Dog with History of Long-Term Phenobarbital Administration

개에서 페노바비탈 장기 투여로 유발된 표재성 괴사성 피부염 1례

  • Chung, Tae-Ho (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Ji-Hyun (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Nam, Eui-Hwa (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Dae-Yong (Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Hyung-Jin (Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University) ;
  • Choi, Min-Cheol (Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University) ;
  • Youn, Jung-Hee (Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University) ;
  • Youn, Hwa-Young (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University) ;
  • Hwang, Cheol-Yong (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University)
  • 정태호 (서울대학교 수의과대학 내과학교실) ;
  • 김지현 (서울대학교 수의과대학 내과학교실) ;
  • 남의화 (서울대학교 수의과대학 내과학교실) ;
  • 김대용 (서울대학교 수의과대학 병리학교실) ;
  • 김형진 (서울대학교 수의과대학 병리학교실) ;
  • 최민철 (서울대학교 수의과대학 영상의학교실) ;
  • 윤정희 (서울대학교 수의과대학 영상의학교실) ;
  • 윤화영 (서울대학교 수의과대학 내과학교실) ;
  • 황철용 (서울대학교 수의과대학 내과학교실)
  • Accepted : 2010.03.31
  • Published : 2010.08.30

Abstract

A dog with a history of long-term phenobarbital administration presented to Seoul National University Hospital for Animals with clinical signs of footpad ulceration and facial ulcerative dermatitis. Skin lesions (facial/footpad dermatitis), histopathologic signs (parakeratotic hyperkeratosis, edema and hyperplasia of the epidermis), and liver involvement (increased plasma liver enzymes and nodular lesions) suggested a diagnosis of superficial necrolytic dermatitis (SND). The patient died suddenly at home of unknown cause after 8 months medical treatment, but intravenous amino acid supplementation and supportive hepatic medication proved as effective for the skin conditions.

10세령의 암컷 말티즈가 족부 괴양 및 안면부 괴양성 피부병으로 서울대학교 수의과대학 동물병원에 내원하였다. 환자는 장기간의 페노바르비탈 투여 경력을 가지고 있었으며, 안면부 및 족부의 피부병변의 분포 양상과 간효소 수치의 상승 및 초음파 영상에서의 간의 저에코성병변들을 참고하여, 최종적으로 피부 생검을 통해 표재성 괴사성 피부염으로 진단하였다. 8개월간의 간보조제 경구 투여 및 아미노산제제의 말초 혈액 투여로 피부 증상은 약간 호전되었으나, 비가역적인 간의 손상은 회복이 힘들었으며, 8개월간의 치료 후 사망하였다.

Keywords

References

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