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Vascular skin disease
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The vasculature of the skin plays a vital role in ensuring various homeostatic mechanisms function as normal, but when disease strikes, the effects can be dramatic. Elizabeth Goodale takes an analytical look at what can go wrong.
Elizabeth Goodale
DVM, Dip. ACVD
Dr. Goodale qualified from the Ontario Veterinary College and followed a small animal rotating internship at the Western College of Veterinary Medicine in Saskatoon. She then spent a year working in private small animal emergency practice before doing a residency in dermatology at UCD, which she completed in 2015. She currently works as a staff dermatologist at UCD.
![Goodale E.](/sites/default/files/images/media/image/41.jpg)
Key Points
- Cutaneous vascular diseases most commonly affect the skin over pressure points and distal extremities such as the footpads, tail, pinnae and scrotum.
- True vasculitis often causes epidermal necrosis and ulceration, and patients are frequently systemically unwell.
- Ischemic dermatopathy, or cell-poor vasculitis, usually causes epidermal lesions of ischemia such as alopecia and collagen changes.
- Several unique familial vasculitis and vasculopathy syndromes have been reported in various breeds of dog.
Introduction
As the largest organ in the body, the skin has a variety of anatomical and physiological functions. The vasculature of the skin is important for thermoregulation, immune function, endocrine function and wound healing, and the hair follicle cycle and normal epidermal turnover are dependent on adequate blood supply. The skin receives about 4% of the total cardiac output, and the cutaneous vasculature is a complex network of plexuses of arteries and veins. The deep plexus contains the major arteries and supplies the subcutaneous tissues, the dermis, the lower portion of the hair follicles and the sebaceous glands. The middle plexus is at the level of the sebaceous glands and supplies the arrector pili muscles, the mid portions of the hair follicles, and the sebaceous glands. The superficial plexus supplies the upper portion of the hair follicles and the epidermis (1). The external ears, footpads, nipples and mucocutaneous junctions (eyelid, lip, nostril, prepuce, anus and vulva) are exceptions to this, which may explain why some vascular diseases affect these locations more commonly.
Without an adequate blood supply, skin lesions can range from alopecia to complete ulceration and necrosis, depending on the size of vessel affected and the severity. Most vascular diseases affecting companion animals primarily affect the smaller vessels. [...]
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