Alopecia in a bulldogFB

Dae Young

• Due Young• Sweet Pea is a one-year-old female French bulldog that has alopecia with scales

and crusts from back of the neck to the tail for about 2 months. Not pruritic.• There was no special history, according to the vet, but a hot spot in the back about

1 month prior to alopecia, which was treated with topical and systemic antibiotics.

• Multiple sections were made from an incisional biopsy. There were multifocal inflammation commonly around hair follicles and adnexal structures.  Inflammatory cells are neutrophils and macrophages but in some areas they are lymphocytes and plasma cells.  The inflammation is generally at the level of isthmus and sebaceous gland location but in the sections examined, the inflammation is not primarily centered in the follicular wall or sebaceous glands.  It is more like locally destructive and dispersed.  There is focal area of furunculosis.   There are some atrophic hair follicles with infundibular dilation with keratin and thin shafts.  Anagen hairs also exist.  Initially I was thinking about possibility of sebaceous adenitis or pseudoplade.  Unusual for a bulldog?

• Thelma Lee Gross• Based on what we have agreed to call sebaceous adenitis, it’s not, nor is it

pseudopelade.  The clinical photos look like pyoderma and you do have a furuncle.  I wonder if it’s all infectious? NOT a straightforward case, for sure!  

• Emily Walder• I agree with Thelma.  It's too pyogranulomatous to be pseudopelade, and I would

expect more severe alopecia clinically.  Way too many sebaceous glands to consider idiopathic SA.  So infection seems most likely.  I also noticed that in the last image in batch 2-1, the pattern of follicular atrophy could be consistent with concurrent cyclic flank alopecia.  Maybe flank alopecia plus pyoderma results in the somewhat unusual inflammatory pattern in these biopsies.

• Carlo Vitale• Yes, clinically it looks like the typical superficial bacterial folliculitis (pyoderma) in this

breed, although a bit severe. Could corticosteroids be involved in the follicular atrophy?

• Marjukka Anttila• to me this looks like something different and is not typical for sebaceous adenitis,

pseudopelade nor bacterial folliculitis. The inflammation seems mostly perifollicular and periadnexal and interstiaI. The hair follicles seem to be going towards telogen phase. I had a similar case with chronic lesions dorsally on the lower back of an Irish setter. I had to leave the diagnosis open since the lesions were so strange. I hoped but could not find evidence of vasculitis.