UNIVERSITY OF LIFE SCIENCES

"KING MICHAEL I OF ROMANIA" FROM TIMIŞOARA

BACHELOR'S DEGREE STUDY PROGRAM

STERILE EOSINOPHILIC PUSTULE,

CANINE SUBCORNEAL PUSTULAR
DERMATITIS, FELINE
HYPEREOSINOPHILIC SYNDROME,
IDIOPATHIC STERILE GRANULOMA

Candidate:

BIANCA AMALIA KÖRTVELYESSY

TIMISOARA
2023
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

CONTAINED
1. STERILE EOZINOFILIC PUSTULA .......................................................................... 2

1.1. CAUSE AND PATHOGENESIS ................................................................................... 2

1.2. CLINICAL FEATURES ................................................................................................ 2
1.4. MANAGEMENT CLINIC ............................................................................................ 3

2. CANINE SUBCORNEAL PUSTULAR DERMATITIS ................................................ 3

1.1. CAUSE AND PATHOGENESIS ................................................................................... 3

1.2. CLINICAL FEATURES ................................................................................................ 3
1.3. DIAGNOSIS.................................................................................................................. 4
1.4. CLINICAL MANAGEMENT ....................................................................................... 5

3. FELINE HYPEREOSINOPHILIC SYNDROME ......................................................... 5

3.1. CAUSE AND PATHOGENESIS ................................................................................... 5

3.2. CLINICAL FEATURES ................................................................................................ 6
3.3. DIAGNOSTIC ............................................................................................................... 7
3.4. MANAGEMENT CLINIC ............................................................................................ 8

4. IDIOPATHIC STERILE GRANULOMA ..................................................................... 8

4.1. CAUSE AND PATHOGENESIS ................................................................................... 8

4.2. CLINICAL FEATURES ................................................................................................ 9
4.2.1. Dog ............................................................................................................................ 9
4.1.1. Cat ............................................................................................................................. 9
4.3. DIAGNOSTIC ............................................................................................................. 10
4.4. MANAGEMENT CLINIC .......................................................................................... 10

1
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

1. STERILE EOSINOFILIC PUSTULE

Sterile eosinophilic pustulosis is a rare idiopathic dermatosis of dogs.

1.1. CAUSE AND PATHOGENESIS

The cause and pathogenesis are unknown. Peripheral eosinophilia, sterile tissue
eosinophilia, and the ability to react to systemic glucocorticoids that characterize this syndrome
suggest that it may be immune-mediated. However, intradermal skin testing, hypoallergenic diets
and immunopathological studies have not been helpful in elucidating etiopathogenesis. Cats also
rarely have clinically and pathologically sterile eosinophilic folliculitis; However, the clinical
presentation is different and lesions are associated with an underlying hypersensitivity such as
atopic disease, food hypersensitivity, hypersensitivity to flea bites and hypersensitivity to
mosquito bites. [25]

1.2. CLINICAL FEATURES

There is no apparent predilection of age, race or gender. The onset of clinical signs is acute,
and the distribution of lesions is multifocal (especially involving the trunk) or generalized. Pruritic,
erythematous, follicular and non-follicular papules and pustules evolve into annular erosions with
epidermal collars. Peripheral spread, central healing and hyperpigmentation of lesions lead to
numerous target lesions. Although most dogs are otherwise healthy, fever, anorexia, depression
and peripheral lymphadenopathy may be present.

1.3. DIAGNOSTIC

Differential diagnosis includes staphylococcal folliculitis, pemphigus foliacea, drug

reaction and subcornish pustular dermatosis. The definitive diagnosis is based on history, physical
examination, blood count, direct smears, cultures and skin biopsy. Most dogs have peripheral

eosinophilia (up to 5.6 × 103/ml). Direct smears reveal numerous eosinophils, nondegenerative
neutrophils, occasional and micro-free acantholytic keratinocytes. [23] Carefully made cultures
are negative. Biopsy reveals one or often a combination of subcornian, intraepidermal, or follicular
eosinophilic pustules. [8] Eosinophilic folliculitis and furunculosis may occur. Flame figures are
occasionally visible in the surrounding dermis. Direct and indirect immunofluorescence results are
negative. Serum α, β and γ globulins may be increased. [26]

2
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

1.4. MANAGEMENT CLINIC

Most dogs respond well to systemic glucocorticoids (oral prednisone or prednisolone, 2.2
to 4.4 mg/kg once daily) within 5 to 10 days. However, stopping treatment constantly leads to
relapses, so long-term morning alternative therapy is indicated, and cure is unlikely. In two dogs
that could not be treated with glucocorticoids, it was good success with dapsone, or the
combination of an antihistamine (diphenhydramine) and a supplement of omega-6 and omega-3
fatty acids.

2. CANINE SUBCORNEAL PUSTULAR DERMATITIS

Subcornian pustular dermatosis is a very rare, sterile, superficial pustular dermatosis of

dogs. It has become a controversial disease, with no new series of cases reported in more than 20
years. Some believe this has been overdiagnosed, and most cases that would be considered
compatible end up being diagnosed as superficial pustular rashes from medications or superficial
pustular dermatophytosis.

1.1. CAUSE AND PATHOGENESIS

The cause of subcornal pustular dermatosis is unknown. In humans, a neutrophil attraction

mechanism such as tumor necrosis factor (TNF)-α has been postulated to be involved;
Autoantibodies are not considered important in pathogenesis. [12] High levels of TNF-α have been
demonstrated in serum and pustules of a man with subcornian pustular dermatosis. Some cases of
human subcornar pustular dermatosis are associated with pyoderma gangrenosum and
immunoglobulin (Ig)A calvopathy and myeloma, but this condition has not been reported in dogs.
[2] , [8]

1.2. CLINICAL FEATURES

There is no apparent predilection of age or gender. Although many breeds were affected,
miniature schnauzers accounted for about 40% of cases. Dachshunds have also been reported as a
suspected breed. [8]

Affected dogs usually have generalized multifocal dermatitis, pustular to seborrhea. The
head and torso, in particular, are affected in a symmetrical way. Intact pustules are usually
nonfollicular, greenish yellow and transient, persisting for only 2 to 4 hours at a time. Thus,
affected dogs often have only circular areas of alopecia, erosion, scaling, crusts and epidermal

3
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

collars. The lesions tend to heal centrally, often with hyperpigmentation, and spread peripherally,
producing annular and serpiginous formations. Rarely, footrests are affected and peel off
superficially. Itching ranges from nonexistent to extreme. The course of dermatosis is often to
erupt and regress. Usually these dogs are otherwise healthy. Occasional dogs have peripheral
lymphadenopathy; rarely, they have pyrexia, anorexia and depression.

Figure 1.1. Subcorneal pustular dermatitis [https://images.app.goo.gl/jfmjuMTFkeidAAJg6]

1.3. DIAGNOSIS

Since this dermatosis is diagnosed by ruling out other conditions, improved diagnostic
techniques should make it rare.

Differential diagnosis includes bacterial folliculitis, pemphigus foliacea, linear IgA pustular
dermatosis, systemic lupus erythematosus, sterile eosinophilic pustulosis, superficial pustular drug
rash and superficial pustular dermatophytosis. The definitive diagnosis is based on history,
physical examination, exclusion by laboratory tests, and response to therapy. Subcornian pustular
dermatosis responds poorly to systemic antibiotics, systemic glucocorticoids and topical agents.
Direct smears from intact pustules usually reveal numerous nondegenerate neutrophils, occasional
acantolytic keratinocytes, and no microorganisms. Carefully made cultures of intact pustules are
usually negative, but a few colonies of coagulase-negative or coagulase-positive staphylococci are
occasionally isolated. The results of immunofluorescence tests are negative. Skin biopsy reveals
intraepidermal (subcornian) pustular dermatitis. [12] Acantholysis is usually minimal, but is
occasionally marked. Neutrophils do not show degenerative changes. Hair follicles are rarely
involved.

Up to half of affected dogs may have mild to moderate mature neutrophilia (13.8–21.1 ×
10.3/ml). Serum protein electrophoresis occasionally reveals increased amounts of α1, α2, and β
globulins. [6]

4
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

1.4. CLINICAL MANAGEMENT

The drug of choice in subcornian pustular dermatosis is dapsone, which is administered

orally at 1 mg/kg every 8 hours. A beneficial response usually occurs within 1 to 4 weeks. In a
minority of cases, therapy can be stopped and lead to long-term remission. More often, however,
the drug is tapered to maintenance levels, with dosage ranging from dog to dog (1 mg / kg once a
day to twice a week).

In dogs, the major side effects of dapsone were hematological and hepatic. Many dogs
experience mild nonregenerative anemia and leukopenia, as well as mild to moderate increases in
serum alanine aminotransferase during induction therapy. If these laboratory abnormalities are not
associated with clinical signs, it is not necessary to stop therapy; Levels will return to normal when
maintenance doses are reached. Dapsone also caused fatal thrombocytopenia in a dog, profuse
leukopenia, occasional vomiting and generalized, erythematous, maculopapular diarrhea and itchy
rash. Dapsone is not authorised for use in dogs. [12]

Very rarely, dogs apparently become resistant to dapsone. They may or may not benefit from
oral administration of sulfasalazine 10 to 20 mg/kg every 8 hours until dermatosis is controlled
and then as needed. Chronic administration of sulfasalazine may be associated with
keratoconjunctivitis sicca. A dog that did not respond to dapsone was successfully treated with
injectable gold salts. [3]

3. FELINE HYPEREOSINOPHILIC SYNDROME

Hypereosinophilic syndrome is a rare disorder of cats. [26] , [19] It has also been recognized
in dogs, but the skin is usually not affected. It is characterized by chronic idiopathic
hypereosinophilia associated with a diffuse infiltration of various organs by mature eosinophils.
[11]

3.1. CAUSE AND PATHOGENESIS

The cause and pathogenesis of this syndrome are unknown. Hypereosinophilia is present
in humans when peripheral blood eosinophil counts exceed 1.5 × 109/L, and hypereosinophilic
syndrome involves idiopathic hypereosinophilia persisting for more than 6 months, non-clonal
eosinophil expansion, and organ damage caused by eosiniphils. [28] It represents a non-neoplastic
leukoproliferative process with migration of eosinophils to different organs. Hypereosinophilia

greater than 1.5 × 109/L occurred secondary to a number of diseases, but was most common in
5
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

cats allergic to fleas and dogs with scabies when skin disease was present. [14] It has been
recommended that peripheral blood eosinophils exceed 5 × 109/L to be considered
hypereosinophilia in dogs and cats.

3.2. CLINICAL FEATURES

The disease is more common in middle-aged female cats. [19] No breed or sex predilection
has been found, but rottweiler dogs appear to be at risk. [13] Infiltration of tissues with maturity
eosinophils lead to dysfunction of multisystem organs. The bone marrow, lymph nodes, liver,
spleen, and gastrointestinal tract are usually affected. Rarely, cardiac abnormalities are found; In
a cat, restrictive cardiomyopathy was a clinical feature. [22] The most common clinical signs
reflect gastrointestinal involvement and include diarrhea, weight loss, vomiting, and anorexia. [10]
Physical examination often reveals thickened intestinal loops, lymphadenopathy, and
hepatosplenomegaly.

Rarely, affected cats have dermatosis characterized by generalized maculopapular

erythema, severe pruritus, marked excoriation, and possibly wheezing and swelling of the soft
tissues of the limbs. [9], [16]

Figure 3.1. Feline hypereosinophilia syndrome [N. Cochet Faivre, 2014]

6
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

Figure 3.2. Feline hypereosinophilia syndrome [N. Cochet Faivre, 2014]

3.3. DIAGNOSTIC

Diagnosis is based on history, physical examination, exclusion of other diagnoses by

laboratory tests and skin biopsy. There are no specific tests for this syndrome; Rather, the
syndrome is defined by a combination of unexplained prolonged eosinophilia and evidence of
multiorgan involvement. Eosinophilic leukemia should be excluded with cellular markers.
Leukemia usually has more immature eosinophils and has been reported not to usually affect the
skin. [6]

Hypersensitivity to fleas, eosinophilic granuloma complex, food hypersensitivity, asthma,

eosinophilic gastroenteritis, endoparasitic infections and mast cell tumors should be excluded.
Another consideration is eosinophilic leukemia, which is very similar but may present with
abnormal cells and an increased M/E ratio greater than 10:1 on bone marrow examination. [10]
Moderate to marked peripheral eosinophilia (mean, 42.6 × 103/ml) is characteristic of cats. Direct
smears of skin lesions reveal a predominance of eosinophils and basophils. Skin biopsy reveals
varying degrees from superficial and deep perivascular dermatitis to interstitial dermatitis, with
eosinophils predominating.

7
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

3.4. MANAGEMENT CLINIC

The prognosis is unfavorable; In most cases, survival times are short and patients do not
respond to any treatment. One dog was reported to go into remission, and another was successfully
treated with hydroxyurea and prednisolone. [18] A cat also responded to hydroxyurea and
prednisolone. [14] Cats with skin lesions may have a slowly progressive disease and longer
survival times (2-4 years). These cats may have a favorable but transient response to high doses
of glucocorticoids. The chemotherapeutic agent hydroxyurea also appears beneficial in dogs and
cats when used together with prednisolone. Hydroxyurea is a ribonucleotide reductase inhibitor
that leads to decreased DNA synthesis. It is mainly lethal to cells in phase S of the growth cycle.
Hydroxyurea led to onychomadesis. [15] Hydroxyurea and interferon alfa are used in humans
when glucocorticoids alone are ineffective. In cases resistant to these therapies, T-cell suppressing
drugs, cyclosporine, or the c-kit inhibitor imatinib mesilate may be useful. [1]

4. IDIOPATHIC STERILE GRANULOMA

Idiopathic sterile granulomatous to nodular pyogranulomatous or plaque skin lesions are

observed in what has been called sterile granuloma / pyogranuloma syndrome (SGPS). [21] This
syndrome is uncommon in dogs and very rare in cats.

4.1. CAUSE AND PATHOGENESIS

The cause and pathogenesis of this syndrome is unknown. It has been speculated that an
immune dysfunction or aberrant response to unidentified infectious agents or antigens from
infectious agents may initiate the response. [7] This is supported by several observations. Some
cases respond to tetracycline or doxycycline, although it is possible that the drugs work through
anti-inflammatory mechanisms. [20] Studies in 46 cases previously diagnosed as SGPS showed
that 21 (46%) are positive for Leishmania by PCR testing and an immunohistochemical technique.
[5] The characteristic granulomatological histopathological appearance, the absence of microbial
agents and foreign material, and the good response to systemic glucocorticoids and cyclosporine
suggest an aberrant inflammatory histiocytological response. [19] In human sarcoidosis, a classic
"sterile" granulomatous disease, polymerase chain reaction (PCR) technology has shown that
mycobacterial DNA (several species) is present in 80% of skin lesions. PCR testing for
mycobacterial antigen was negative in all 46 cases examined in a single study. [5] Other infectious
agents, such as tickborne infectious disease, may also be good candidates to evaluate in these cases.

8
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

4.2. CLINICAL FEATURES

4.2.1. Dog

The disorder can occur in dogs of all ages, breeds, and genders, but collies, dachshunds,
Doberman pinschers, English bulldogs, Weimaraners, Great Danes, boxers, and golden retrievers
may be predisposed. [7] , [20] The lesions are firm, painless, nonpruritic dermal papules, plaques
and nodules. The lesions can develop into donut-shaped circular lesions and become alopecia,
ulcerated and secondarily infected. The lesions are usually multiple and usually affect the head
(especially the bridge of the nose, muzzle and periocular region), pinnae and paws. One patient
had lesions involving the tongue, in addition to more typical lesions. [4] Injuries have also been
observed involving the foreskin. Animals are usually otherwise healthy. A dog with sterile
pyogranuloma syndrome had associated hypercalcemia.

Figure 4.1. Alopecia and erythematosus dermatitis with ulcerative wounds on the head (A), right limb (B),
dorsal region (C), ventral region (D), [Kawarai, 2014]

4.1.1. Cat

In cats, papules firm to nodules develop and can coagulate into plaques. The lesions are
usually erythematous to purplish in color, although some may be orange-yellow. These plates
become reddish purple on palpation. Lesions are often found on the head, muzzle and pinna, but
can also appear on the paws and less commonly, truncally. In some cats, lesions may be itchy, but
this is a variable finding.

9
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

4.3. DIAGNOSTIC

Differential diagnosis includes other granulomatous and pyogranulomatous (bacterial,

mycotic, foreign) and neoplastic disorders. The definitive diagnosis is based on history, physical
examination, cultures, and biopsy. Major differential diagnoses are infectious diseases.
Cytological examination reveals pyogranulomatous or granulomatous inflammation without
microorganisms. In rare cases of mycobacterial diseases, direct smears from lesions reveal
mycobacteria; Tissue samples fixed by formalin are usually negative. Direct stained smears with
rapid acid spots for mycobacteria should be cytologically examined. Cultures (aerobic, anaerobic,
mycobacterial, and fungal) are best grown from tissues taken by aseptic surgical biopsy techniques
and are negative. Biopsy usually reveals nodular to diffuse, granulomatous to pyogranulomatous
dermatitis. In general, the center is more neutrophilic; The outer peripheral infiltrate has several
macrophages. [5] A case that was granulomatous with minimal neutrophil component was
diagnosed as sterile sarcoidal granuloma, and this was included in SGPS by some authors and
considered a separate sterile granulomatous disease by others. [7] , [26] Different orientations of
the infiltrate can be seen depending on the stage being biopsied. Special stains will be negative,
since the diagnosis is based on determining the lesion is sterile. Although few reports involving
PCR testing are available, it is obviously indicated; we may find that the diagnosis should only be
made after obtaining negative PCR results. In areas where Exists Leishmania or in dogs or cats
that have been in endemic areas leishmania, this should at least be tested by PCR before making
a diagnosis. [20]

4.4. MANAGEMENT CLINIC

A study of tetracycline and niacinamide or doxycycline and niacinamide is warranted

before stronger immunosuppressive drugs. Tetracycline and niacinamide are administered at 250
mg every 8 hours in dogs under 10 kg and 500 mg every 8 hours in dogs over 10 kg. Surgical
excision of solitary lesions may be necessary if pharmacotherapy is ineffective. Systemic
glucocorticoids may be helpful in cases of multiple injuries where surgery is impractical or
diseased recommended. In dogs, prednisone or prednisolone is administered orally at 2.2 to 4.4
mg/kg once daily until lesions have regressed, usually between 7 and 14 days. About 60% of dogs
then require prolonged therapy with morning alternating glucocorticoids. [17]

Occasionally, dogs do not respond to glucocorticoids or become refractory after variable

periods of remission. Cyclosporine (Atopic [Novartis]) 5 to 7mg/kg once daily alone or in
combination with prednisone may be effective. Azathioprine is also useful in such cases and is
10
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

taken orally at 2.2 mg/kg once daily until remission, then on alternate days. Once remission has
been maintained for several months, therapy can be successfully discontinued in some cases.
Others may require long-term low-dose therapy. We were occasionally able to reduce the dose and
frequency of azathioprine to 0.25 mg/kg once weekly. In cats, similar regimens can be used, except
that chlorambucil is used instead of azathioprine. In cats, lesions often resolve spontaneously after
about 9 months. [26]

11
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

BIBLIOGRAPHY

Books, articles from specialized magazines

1. Aroch, I, Perl, A, Markovics, A., 2001, Disseminated eosinophilic disease resembling

idiopathic hypereosinophilic syndrome in a dog. Vet Rec..
2. Cheng, S, Edmonds, E, Ben-Gashir, M, et al., 2008, Subcorneal pustular dermatosis: 50
years on. Clin Exp Dermatol..

3. Clasper, M., 1991, Successful use of gold in the treatment of a case of canine sub-corneal
pustular dermatosis. N Z Vet J..

4. Cornegliani, L, Fondevila, D, Vercelli, A, et al., 2005, PCR technique detection of

Leishmania spp. but not Mycobacterium spp. in canine cutaneous sterile
pyogranuloma/granuloma syndrome. Vet Dermatol..

5. Diaz, SF, Gilbert, S., 2007, Oral lesions in a case of sterile granuloma and
pyogranuloma syndrome. Vet Derm Abst..

6. Gross, T, et al., 2005 , Nodular and diffuse diseases of the dermis with prominent
eosinophils, neutrophils or plasma cells. In: Skin Diseases of the Dog and Cat, Clinical
and Histopathologic Diagnosis. Ames: Blackwell Science.

7. Gross, TL, et al., 2005, Noninfectious nodular and diffuse granulomatous and
pyogranulomatous diseases of the dermis. In: Skin Diseases of the Dog and Cat, Clinical
and Histopathologic Diagnosis. Ames, Iowa: Blackwell Science.

8. Gross, TL, et al., 2005, Pustular and nodular diseases without adnexal destruction. In:
Skin Diseases of the Dog and Cat, Clinical and Histopathologic Diagnosis. Ames, Iowa:
Blackwell Science.
9. Harvey, R., 1990 , Feline hypereosinophilia with cutaneous lesions. J Small Anim Pract..

10. Huibregtse, BA, Turner, JL., 1994, Hypereosinophilic syndrome and eosinophilic
leukemia: a comparison of 22 hypereosinophilic cats. J Am Anim Hosp Assoc..

11. James, FE, Mansfield, CS., 2009, Clinical remission of idiopathic hypereosinophilic
syndrome in a Rottweiler. Aust Vet J..

12. Kalaher, KM, Scott, DW., 1990, Subcorneal pustular dermatosis in dogs and in human
beings: comparative aspects. J Am Acad Dermatol.

12
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

13. Lilliehöök, I, Gunnarsson, L, Zakrisson, G, et al., 2000, Diseases associated with

pronounced eosinophilia: a study of 105 dogs in Sweden. J Small Anim Pract..

14. Lilliehook, I, Tvedten, H., 2003, Investigation of hypereosinophilia and potential

treatments. Vet Clin North Am Small Anim Pract..

15. Marconato, L, Bonfanti, U, Fileccia, I., 2007 , Unusual dermatological toxicity of

hydroxyurea in two dogs with spontaneously occurring tumours. J Small Anim Pract..

16. Muir, P, Gruffydd-Jones, TJ, Brown, PJ., 1993, Hypereosinophilic syndrome in a cat. Vet
Rec..

17. Panich, R, Scott, DW, Miller, WH., 1991, Canine cutaneous sterile pyogranuloma
syndrome: A retrospective analysis of 29 cases (1976–1988). J Am Anim Hosp Assoc.
27(519–528)..

18. Perkins, MC, Watson, ADJ., 2001, Successful treatment of hypereosinophilic syndrome
in a dog. Aust Vet J..

19. Robson, DC, Burton, GG., 2003, Cyclosporin: applications in small animal dermatology.
Vet Dermatol..

20. Santoro, D, Prisco, M, Ciaramella, P., 2008, Cutaneous sterile

granulomas/pyogranulomas, leishmaniasis and mycobacterial infections. J Small Anim
Pract..

21. Santoro, D, Spaterna, A, Mechelli, L, et al., 2008, Cutaneous sterile

pyogranuloma/granuloma syndrome in a dog. Can Vet J..

22. Saxon, B, Hendrick, M, Waddle, JR., 1991 , Restrictive cardiomyopathy in a cat with
hypereosinophilic syndrome. Can Vet J..

23. Scott, DW, Buerger, RG, Miller, WH., 1990, Idiopathic sterile granulomatous and
pyogranulomatous dermatitis in cats. Vet Dermatol..

24. Scott, DW, et al., 1989, Sterile eosinophilic folliculitis in the cat: An unusual
manifestation of feline allergic skin disease? Comp Anim Prac..

25. Scott, DW, Miller, WH, Jr., Griffin, CE., 2001, Muller and Kirk’s Small Animal
Dermatology, ed 6. Philadelphia: WB Saunders.

26. Scott, DW., 1987, Sterile eosinophilic pustulosis in dog and man: comparative aspects. J
Am Acad Dermatol.

13
STERILE EOSINOPHILIC PUSTULE, SUBCORNEAL PUSTULAR DERMATITIS, BIANCA AMALIA KÖRTVELYESSY
HYPEREOSINOPHILIC SYNDROME, IDIOPATHIC STERILE GRANULOMA

27. Tefferi, A, Gotlib, J, Pardanani, A., 2010 , Hypereosinophilic syndrome and clonal
eosinophilia: point-of-care diagnostic algorithm and treatment update. Mayo Clin Proc..

Web site-uri

1. , https://images.app.goo.gl/jfmjuMTFkeidAAJg6, accessed 20.05.2023.

2. N. Cochet Faivre, P. Prelaud, E. Bensignor, J. Declercq, V. Defalque, 2014,

https://www.sciencedirect.com/science/article/abs/pii/S2214567214000611, Three cases
of feline hypereosinophilic syndrome treated with imatinib mesilate, Revue Vétérinaire
Clinique, Volume 49, Issue 4, accesat 20.05.2023.

3. Kawarai, Shinpei & Matsuura, Shinobu & Yamamoto, Saburo & Kiuchi, Akio &
Kanemaki, Nobuyuki & Madarame, Hiroo & Shirota, Kinji. 2014,
https://www.researchgate.net/publication/262582557_A_Case_of_Cutaneous_Sterile_Py
ogranulomaGranuloma_Syndrome_in_a_Maltese, A Case of Cutaneous Sterile
Pyogranuloma/Granuloma Syndrome in a Maltese, Journal of the American Animal
Hospital Association, accesat 24.05.2023.

14