title: Dinotefuran/pyriproxyfen/permethrin pemphigus-like drug reaction in three dogs.
abstract: BACKGROUND
  Pemphigus foliaceus (PF) can occur spontaneously or as a reaction pattern associated with cutaneous adverse drug reactions.
  
  
  OBJECTIVE
  To provide clinical, histological and immunological assessments of three dogs that developed cutaneous adverse drug reactions following application of a topical flea and tick control product, which contained dinotefuran, pyriproxyfen and permethrin.
  
  
  METHODS
  Three client-owned dogs.
  
  
  RESULTS
  The dogs exhibited rapid onset of papules, pustules and crusts at the site of application of the flea control product. In two dogs, the lesions became generalized, while the third exhibited a localized phenotype. Both dogs with generalized lesions required immunosuppressive treatment; one achieved remission after 1 year of treatment and one was euthanized due to adverse effects of glucocorticoids. The dog with a localized phenotype was treated with topical glucocorticoids exclusively and achieved remission after 10 months. Histology revealed subcorneal pustular dermatitis, with acantholysis of keratinocytes and focal to multifocal full-thickness epidermal necrosis. These features are similar to those previously reported for pesticide-triggered and spontaneous PF. Tissue-bound IgG was detected in two of three dogs, and autoantibodies targeting canine desmocollin-1 were identified in the serum of the one dog from which a sample was available.
  
  
  CONCLUSIONS
  Cutaneous adverse drug reaction caused by a flea control product containing dinotefuran, pyriproxyfen and permethrin closely resembled those reported for other pesticide-associated PF-like cutaneous adverse drug reactions. Although it appears to be a rare entity, clinicians and pathologists should be aware of the potential for flea and tick control products to trigger PF-like reactions.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.|Center for Comparative Medicine and Translational Research, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Petra
authors.initials: P
authors.lastname: Bizikova
authors.affiliation: Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive West, Madison, WI, 53706, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Moriello
authors.affiliation: Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.
authors.forename: Keith E
authors.initials: KE
authors.lastname: Linder
authors.affiliation: Tulsa Veterinary Dermatology, Inc., 7220 East 41st Street, Tulsa, OK, 74145, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Sauber
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000139:chemically induced* / Q000473:pathology; D004285:Dogs; D004338:Drug Combinations; D006146:Guanidines / Q000009:adverse effects*; D008297:Male; D000073943:Neonicotinoids; D009574:Nitro Compounds / Q000009:adverse effects*; D010392:Pemphigus / Q000139:chemically induced / Q000473:pathology / Q000662:veterinary*; D026023:Permethrin / Q000009:adverse effects*; D010575:Pesticides / Q000009:adverse effects*; D011725:Pyridines / Q000009:adverse effects*; D012867:Skin / Q000187:drug effects / Q000473:pathology
chemical_list: D004338:Drug Combinations; D006146:Guanidines; D000073943:Neonicotinoids; D009574:Nitro Compounds; D010575:Pesticides; D011725:Pyridines; C465368:dinotefuran; C055613:pyriproxyfen; D026023:Permethrin