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Skin Blisters (Vesiculopustular Dermatoses) in Dogs

Vesiculopustular Dermatoses in Dogs

A vesicle, or blister, is a small, raised area on the skin’s outer layer (known as the epidermis) filled with serum, a clear watery fluid that separates from the blood. Similarly, a pustule is a small, raised area on the skin’s outer layer filled with pus — a mixture of serum, white blood cells, cellular debris, and dead tissue.

The prefix “vesiculo” pertains to vesicles, indicating the diseased condition associated with the cause of the blister. Meanwhile, “pustular” describes an organism covered in pustules. “Dermatoses” is the plural form of dermatosis, used to denote any abnormality or disorder of the skin.

Symptoms

One or more of the following signs may manifest:

  • Hair loss
  • Reddened skin
  • Vesicles or blisters: small raised areas on the skin’s outer layer filled with clear fluid
  • Pustules: small raised areas on the skin’s outer layer filled with pus
  • Loss of pigment of the skin and/or hair

Causes

Vesicles

  • Systemic lupus erythematosus – SLE; an autoimmune disease where the body attacks its own skin and possibly other organs
  • Discoid lupus erythematosus – DLE; an autoimmune disease affecting the skin only, typically the face
  • Bullous pemphigoid – an autoimmune disease resulting in skin ulceration and/or moist tissue involvement
  • Pemphigus vulgaris – a severe autoimmune disease leading to mouth ulceration and junctional tissue and skin ulcers
  • Dermatomyositis – an inflammatory disorder impacting the skin and muscles in collies and Shetland sheepdogs

Pustules

  • Skin infection involving the skin’s surface (known as superficial skin infection), characterized by pus presence (pyoderma)
  • Bacterial skin infection involving areas with sparse hair coat (impetigo)
  • Superficial spreading pyoderma
  • Superficial bacterial infection/inflammation of hair follicles (bacterial folliculitis)
  • Acne
  • Pemphigus complex – autoimmune skin diseases
  • Pemphigus foliaceus
  • Pemphigus erythematosus
  • Pemphigus vegetans
  • Subcorneal pustular dermatosis (skin disease with unknown cause characterized by pustule presence)
  • Dermatophytosis (fungal skin infection)
  • Sterile eosinophilic pustulosis – a skin disorder marked by eosinophil presence in pustules; eosinophils are white blood cells involved in allergic responses and parasite larvae defense
  • Linear immunoglobulin A (IgA) dermatosis – a skin disorder seen solely in dachshunds where sterile pustules are beneath the skin surface; immunoglobulin A [IgA] is present in the skin’s lowest layer (basement membrane); immunoglobulins are proteins produced by immune system cells, including antibodies categorized into classes like immunoglobulin A [IgA]

Diagnosis

You should provide a comprehensive history of your dog’s health, including symptom background and potential triggering incidents. Your veterinarian will conduct a thorough physical examination on your dog, along with blood chemical profiling, complete blood count, electrolyte panel, and urinalysis.

The physical examination will involve a dermatological assessment, during which skin biopsies may be taken for histopathological examination. Microscopic examination and bacterial, mycobacterial, and fungal cultures should be performed on skin scrapings.

Treatment

The majority of dogs can receive treatment as outpatients. Nevertheless, dogs with systemic lupus erythematosus (SLE), pemphigus vulgaris, and bullous pemphigoid may have progressed to severe illness and will necessitate intensive inpatient care.

Living and Management

Consult your veterinarian about the potential benefits of periodic bathing using an antimicrobial shampoo to eliminate surface debris and manage secondary bacterial infections. Your veterinarian will arrange follow-up appointments to monitor your dog’s bloodwork. Initially, these appointments may occur every 1-2 weeks. Over time, the frequency of visits may decrease to once every three to four months, depending on your dog’s response to the medication.

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