What is Skin Blisters (Vesiculopustular Dermatoses)?
Vesiculopustular dermatosis is a skin condition characterized by blisters or vesicles. A vesicle is a lipid-enclosed pocket inside a cell. On the outer layer of the skin, these appear as small raised bubbles filled with a clear or pus-like liquid that contains disease-fighting white blood cells. Erythema, areas of reddened skin, are often present as well, and the blisters may pop and become inflamed causing sores and ulceration. Dogs can develop vesiculopustular dermatoses in response to a variety of problems. The most common and treatable is the bacterial skin infection called pyoderma, which is defined by the presence of bacteria and pus-filled blisters. Fungal infections such as dermatophytosis (ringworm) can also cause blistering. Allergic reactions to some drugs may be another reason for vesiculopustular dermatosis in dogs, however, chronic blistering without infection is most commonly an autoimmune response in which antibodies attack the cells and proteins in the outer layer of the skin. There are many different inherited conditions with an immune-mediated mechanism that causes blistering; diseases run in families and are more common in certain breeds. Systemic lupus is the most serious, but bullous pemphigoid and several pemphigus complex disorders can also cause quite severe blistering and ulceration. Depending on the severity, many of these problems can be controlled with immunosuppressant medication. A few are not treatable.
Vesiculopustular dermatosis is any change to the skin that involves blistering or pustules. It is a nonspecific symptom that could be a sign of many different diseases, including bacterial infection or an autoimmune response.
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Symptoms of Skin Blisters (Vesiculopustular Dermatoses) in Dogs
Symptoms may be generalized (covering the entire body) or they may be confined to a specific area.
- Areas of blistering skin
- Pus-filled pockets resembling pimples
- Severe sores and ulceration
- Flaking, scaling skin
- Loss of pigment in the nose
- Erythema (patches of reddened skin)
- Alopecia (hair loss)
- Blistering areas confined to the head and feet
- Blistering in the junction between different areas of skin, such as around the mouth, nose, anus, or vagina
These are the two types of vesiculopustular dermatoses.
- Pustular –filled sores resembling pimples
- Vesicular –blisters filled with clear liquid
The presence of pustules or vesicles can help the veterinarian identify your dog’s disease, although some dogs may have a combination of both types.
Causes of Skin Blisters (Vesiculopustular Dermatoses) in Dogs
These are some of the diseases that cause vesiculopustular dermatoses in dogs, as well breeds with a higher rate of incidence.
- Bacterial infection
- Fungal infection that is more common in puppies
Demodicosis or demodectic mange
- Mite infestation
Hereditary Immune-Mediated Diseases
Systemic or cutaneous lupus erythematosus (SLE or CLE)
- SLE can affect muscles, joints, blood, or kidneys as well as the skin, while CLE only has cutaneous symptoms
- Collies, Shetland Sheepdogs, German Shepherds
- The most common form of the pemphigus complex with generalized pustules all over the body
- Akitas, Chow Chows, Dachshunds, Bearded Collies, Newfoundlands, Doberman Pinschers, Schipperkes, Finnish Spitzes, Newfoundlands
- A milder form of pemphigus foliaceus with symptoms only on the head and feet
- Collies, German Shepherds, Shetland Sheepdogs
- The most severe form of the pemphigus complex with blisters and severe ulceration in the mouth or other places where the skin and mucus membranes join
- An autoimmune response that attacks a protein in the skin. Dogs often have blisters in the mouth and nose
- Collies, Doberman Pinschers
Sterile eosinophilic pustulosis
- An allergic rash characterized by pustules with high numbers of eosinophils
Subcorneal pustular dermatosis
- Pustules and crusting on the feet
Linear IgA dermatosis
- A skin disorder with pustules located just below the surface of the skin
- Dachshunds only
- A hereditary disorder that causes blistering on the skin in response to mild trauma
- An inherited disease that causes inflammatory damage to the muscles and skin in young dogs
- Most skin symptoms affect the face
- Collies, Shetland Sheepdogs, sometimes Chow Chows
Cutaneous drug eruption
An allergic skin reaction to certain medications
Diagnosis of Skin Blisters (Vesiculopustular Dermatoses) in Dogs
The veterinarian will examine your dog’s symptoms. Bloodwork and urinalysis will check for systemic illness. SLE and some other autoimmune responses may be evident on a blood test. Other testing will focus on eliminating treatable causes like bacterial, fungal, or parasite infection. The presence of these organisms can often be found on a small skin sample, but a biopsy will be needed to evaluate the condition more extensively and identify specific autoimmune responses. This is usually performed with a local anesthetic. A muscle biopsy may also be needed for dogs with suspected dermatomyositis.
In some cases in can be difficult to distinguish a specific type of autoimmune disorder, even with a biopsy. Your dog’s age and breed will be relevant, as well as the specific type of symptoms including pustules or vesicles and any signs of systemic illness. Recent exposure to a new drug is also relevant, since allergic reactions could cause similar symptoms.
Treatment of Skin Blisters (Vesiculopustular Dermatoses) in Dogs
Antibiotic or antifungal medication may be prescribed for to treat infections. If this is the primary cause, treatment will be effective. Antibiotic-resistant bacterial infections may need to be treated with a non-beta lactam antibiotic.
Autoimmune responses will be treated with immunosuppressant medication. Chemotherapy drugs may be used to debilitate the immune system for very for severe problems like SLE, pemphigus, or bullous pemphigoid. Dogs with these diseases can sometimes be very ill and may need immediate supportive treatment or hospitalization. Prednisone, or glucocorticoid medication may be prescribed for less severe autoimmune responses. Pentoxifylline is used to treat dermatomyositis since prolonged prednisone treatment increases muscle atrophy.
Vitamin E and fatty acid supplements can help support overall skin health. Medicated shampoos may be recommended to eliminate flaking skin and help to keep secondary bacterial infections in check. There is no effective treatment for epidermolysis bullosa other than managing symptoms and trying to eliminate trauma as much as possible.
Recovery of Skin Blisters (Vesiculopustular Dermatoses) in Dogs
If bacterial or fungal infection is the primary problem, your dog is likely to make a full recovery, however an inherited autoimmune disorder usually needs intermittent treatment and careful long-term management. Many symptoms go into remission with treatment, but may flare up again at a later date. The veterinarian will taper off your dog’s medication as symptoms become milder since taking high doses of an immune suppressant increases susceptibility to infection. Frequent check-ups may be needed to monitor your dog’s symptoms and adjust dosage as necessary.
Keeping your dog in good health can help to reduce the likelihood of secondary infection. A healthy diet, good hygiene practices, and dietary supplements recommended by a veterinarian can help to maintain your dog’s immune system while taking strong steroid or chemotherapy drugs. Avoiding exposure to sunlight can also help to reduce the severity of some autoimmune responses. With most conditions breeding is inadvisable as it can pass the problem on to future offspring.
Skin Blisters (Vesiculopustular Dermatoses) Questions and Advice from Veterinary Professionals
My dog has a rash that is scabbing and developing pus filled blisters/pimples on her stomach and private areas. She is not excessively itching or in discomfort. The conditions have persisted for less than a week. I have given her two baths in the last week and have used anti itch creams. What should I use/be using?
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My dog has a blister like bump on outside of cooter.. as I look it up it's like an infection. She also has these little circles of rashes between her legs on her skin going toward her belly..
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I believe my dachshund has linear IgA dermatosis. What is the best treatment for him? I feel so bad for him, scratching and biting. I have been doing hydrocortisone shampoos to the affected area twice weekly and have been trying different creams, gels,and lotions. I'm afraid I may be causing more harm than good. Also, he just finished 2 weeks of Cephalexin with no improvement. Sincere thanks
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My dog has blisters that just started forming this morning. They are mostly around his eyes and seem to be growing quite rapidly in even a few hours. What is the best course of action?
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