小動物疾病系統

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犬原發性皮脂漏
作者
林涵淵、賴政宏、鄭豐邦
中文病名 犬原發性皮脂漏
英文病名 Canine primary seborrhea
疾病描述
一、疾病特性
    原發性皮脂漏為一先天性角化異常疾病,在犬隻較為常見,好發於美國可卡獵犬(American Cocker spaniels)、英國激飛獵犬(English Springer spaniels)、西高地白㹴(West Highland White terriers)、巴吉度獵犬(Basset hounds)、英國鬥牛犬(English bulldog)、德國狼犬(German shepherd dog)、杜賓犬(Doberman pinscher)、愛爾蘭長毛獵犬(Irish setter)、沙皮犬(Chinese shar -pei)、迷你雪納瑞犬(miniature schnauzer)、查理士王小獵犬(Cavalier King Charles spaniel)、臘腸犬(dachshund)以及拉不拉多犬(Labrador retriever)。這些品系之純種犬可能因部分基因缺陷,發展成先天性表皮細胞異常,造成表皮結構之毛根外鞘、皮脂腺等過度增生,此種症狀稱為皮脂漏。目前研究顯示此病並無性別之特異性,大多好發於幼年期至兩歲齡。有病例報告指出曾發現於波斯貓品種,但此病在貓隻相對地十分罕見。
 
二、致病機制
    由於表皮結構之異常缺陷,顯示表皮微環境之改變,皮脂過度分泌,使細菌容易滋生,而造成皮膚反復性之細菌感染。除了常見的葡萄球菌感染,酵母菌如Malassezia pachydermatis與念珠菌,亦為常見的伺機性病原。上述提到之皮膚常在菌,在原發性皮脂漏病犬會因微環境改變而併發其他皮膚疾病,亦常見併發外耳炎。
 
三、臨床症狀

    約半數患犬有復發性淺層或深層細菌性膿皮症,於幼犬時期發病可能較為輕微,隨著年齡增長,其病情漸趨嚴重,也可能併發其他疾病。常見臨床症狀為無光澤之被毛、大量皮屑伴隨follicular casts之病變(毛幹上附著之角質與毛囊物質)、皮脂分泌物過多、痂皮以及油膩帶有異味之皮膚。發病區域可為局部性或全身性,其中趾間、會陰、臉部、腋窩、腹部、頸部腹側與皮膚皺摺處多為症狀嚴重區域,或是局限於軀幹部,伴隨中度至強烈的搔癢情形,且常併發外耳炎。慢性病例常出現苔癬化、脫毛、色素沉著以及油膩性滲出物。

診斷方法
1.          根據臨床症狀與相關檢查,排除其他可能造成繼發性皮脂漏之病因後,可確診為原發性皮脂漏。
一般造成繼發性皮脂漏之可能病因大致可分為下列數種
感染性:細菌、黴菌等。
過敏性:異位性皮膚炎、食物過敏、跳蚤過敏等。
內分泌或營養代謝性疾病:鋅反應性皮膚病、糖尿病、甲狀腺功能低下症、庫興氏症等。
寄生蟲:毛囊蟲、疥癬蟲等。
免疫調節:免疫性皮脂腺炎、紅斑性狼瘡等。
腫瘤:親上皮性表皮腫瘤

皮膚採樣進行組織病理學檢查之結果,通常無診斷特異性。

治療方法
1.          給予病犬正確且均衡之飲食,並可於食物中添加適量之飽和與不飽和脂肪酸、維生素等;避免給予易誘發食物過敏之飲食。
2.          針對繼發性之細菌或酵母菌感染,給予藥物與外用藥膏治療;搭配去油脂之洗毛精,初期嚴重時需2-7天使用一次,之後依據病情逐漸調整使用時間。
3.          已控制病情之病畜,可逐漸調整藥物劑量至最低,由獸醫師觀察停藥後是否復發。
4.於嚴重皮脂漏與強烈搔癢之個例,可酌量使用類固醇,但應避免長期使用,以減少類固醇誘發之副作用。
預防控制方法
1.          預後須根據個體發病與嚴重程度、治療效果等多方面評估,但此病為先天皮膚結構缺陷,無法完全治癒,只能達到控制病情。
2.          需長期追蹤病畜以預防復發性感染,並使用減少皮脂分泌的洗毛精與潤膚精,能夠有效控制皮脂漏的危害。
3.          病情輕微之病畜,可於控制病情後由獸醫師決定是否停藥。

4.  發病犬隻避免進行配種,以減少缺陷基因遺傳。

相關圖片 <p class="MsoNoSpacing" style="margin: 0cm 0cm 0pt"><span style="font-family: 標楷體; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">病犬瀰漫性皮脂漏現象,在剃毛後可見大量皮屑、痂皮與滲出液遍布全身。</span><span lang="EN-US" style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 標楷體"><o:p></o:p></span></p>
<p><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">(</span><span style="font-size: 12pt; font-family: 標楷體; mso-ascii-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">圖片來源:</span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">Hnilica K. </span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">2011. Keratinization and Seborrheic Disorders. In: ed. Small Animal Dermatology (Third Edition). W.B. Saunders, Saint Louis, </span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 新細明體; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">367-370.</span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">)</span></p>
Close<p class="MsoNoSpacing" style="margin: 0cm 0cm 0pt"><span style="font-family: 標楷體; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">病犬瀰漫性皮脂漏現象,在剃毛後可見大量皮屑、痂皮與滲出液遍布全身。</span><span lang="EN-US" style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 標楷體"><o:p></o:p></span></p>
<p><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">(</span><span style="font-size: 12pt; font-family: 標楷體; mso-ascii-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">圖片來源:</span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">Hnilica K. </span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">2011. Keratinization and Seborrheic Disorders. In: ed. Small Animal Dermatology (Third Edition). W.B. Saunders, Saint Louis, </span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 新細明體; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">367-370.</span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">)</span></p>

<p class="MsoNoSpacing" style="margin: 0cm 0cm 0pt"><span style="font-family: 標楷體; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">病犬瀰漫性皮脂漏現象,在剃毛後可見大量皮屑、痂皮與滲出液遍布全身。</span><span lang="EN-US" style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 標楷體"><o:p></o:p></span></p> <p><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">(</span><span style="font-size: 12pt; font-family: 標楷體; mso-ascii-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">圖片來源:</span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">Hnilica K. </span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">2011. Keratinization and Seborrheic Disorders. In: ed. Small Animal Dermatology (Third Edition). W.B. Saunders, Saint Louis, </span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 新細明體; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">367-370.</span><span lang="EN-US" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family: 標楷體; mso-font-kerning: 1.0pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-TW; mso-bidi-language: AR-SA">)</span></p>


參考文獻
1.          Hnilica K. 2011. Keratinization and Seborrheic Disorders. In: ed. Small Animal Dermatology (Third Edition). W.B. Saunders, Saint Louis, 367-370.
2.          Paradis M, Scott DW, 1990. Hereditary primary seborrhea oleosa in Persian cats. Feline Pract. 18(1): 17-20.
3.          Scott DW, Miller WH, 1996. Primary seborrhoea in English springer spaniels: A retrospective study of 14 cases. J Small Anim Pract. 37(4):173-178.
4.          Scott DW, Paradis M, 1990. A survey of canine and feline skin disorders seen in a university practice: Small Animal Clinic, University of Montreal, Saint-Hyacinthe, Quebec (1987-1988). Can Vet J. 31: 830-835.

5.Yurayart C, Chindamporn A, Suradhat S, Tummaruk P, Kajiwara S, Prapasarakul S, 2011. Comparative analysis of the frequency, distribution and population sizes of yeasts associated with canine seborrheic dermatitis and healthy skin. Vet Microbiol. 148(2-4): 356-362.

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