{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:30:17Z","timestamp":1768350617661,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Veterinary Dermatology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A new canine subgroup defined as \u2018old\u2010dog\u2019 or \u2018hyperkeratotic\u2019 erythema multiforme (HKEM) with marked hyperkeratosis and parakeratosis has been proposed without any detailed description of larger case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We report herein the signalment, clinical signs, treatment outcome, and histopathological and immunological findings in 17 dogs with HKEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Animals<\/jats:title><jats:p>Inclusion criteria were the presence of (i) scaly skin lesions with or without crusting; and (ii) microscopic lesions typical of EM (i.e. a panepidermal cytotoxic lymphocytic dermatitis with or without basal keratinocyte apoptosis); and (iii) microscopic ortho\u2010 and\/or parakeratotic hyperkeratosis affecting the interfollicular epidermis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Clinical questionnaires and skin biopsies were reviewed. Polymerase chain reactions for epidermotropic viruses and direct immunofluorescence were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Various breeds were affected with an over\u2010representation of males in their mid\u2010to\u2010late adulthood (median age 9\u2009years). Generalised skin lesions included multifocal\u2010to\u2010coalescing, linear and annular macules and plaques with erythema and adherent firm crusting. Microscopic lesions were specific for EM and featured prominent superficial epidermal apoptosis with lymphocytic satellitosis and parakeratosis. No drug triggers were identified. Polymerase chain reactions for canine herpesvirus polymerase gene, canine parvovirus and canine distemper virus were negative in all HKEM and canine erosive EM (15 dogs) biopsies. Lesions failed to respond to oral and\/or topical antimicrobials. Complete remission of signs was achieved in 9 of 17 dogs (53%) using immunosuppressive regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Clinical Relevance<\/jats:title><jats:p>Hyperkeratotic erythema multiforme (HKEM) is a chronic, persistent and clinically distinctive erythema multiforme (EM) variant that differs from \u2018classic\u2019 vesiculobullous erosive\u2010to\u2010ulcerative EM in dogs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vde.13141","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T06:58:00Z","timestamp":1670914680000},"page":"125-133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Hyperkeratotic erythema multiforme variant in 17 dogs"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4785-4121","authenticated-orcid":false,"given":"Frane","family":"Banovic","sequence":"first","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1399-0034","authenticated-orcid":false,"given":"Thierry","family":"Olivry","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine NC State University  Raleigh North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Artlet","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Rothstein","sequence":"additional","affiliation":[{"name":"Animal Allergy and Dermatology Service of Connecticut  Plantsville Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Beco","sequence":"additional","affiliation":[{"name":"Cabinet V\u00e9t\u00e9rinaire  Spa Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Linek","sequence":"additional","affiliation":[{"name":"Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Zabel","sequence":"additional","affiliation":[{"name":"VCA Northwest Veterinary Specialist, Dermatology Allergy &amp; Otology Service  Clackamas Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanine","family":"Peters\u2010Kennedy","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine Cornell University  Ithaca New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Welle","sequence":"additional","affiliation":[{"name":"Institute of Animal Pathology, Vetsuisse Faculty University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Wilkes","sequence":"additional","affiliation":[{"name":"Department of Comparative Pathobiology\/Animal Disease Diagnostic Laboratory Purdue University College of Veterinary Medicine  West Lafayette Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Austel","sequence":"additional","affiliation":[{"name":"Department of Small Animal Medicine and Surgery, College of Veterinary Medicine University of Georgia  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Linder","sequence":"additional","affiliation":[{"name":"Department of Population Health and Pathobiology, College of Veterinary Medicine NC State University  Raleigh North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2011.05348.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57090921"},{"key":"e_1_2_9_4_1","first-page":"337","article-title":"Misdiagnosis of erythema multiforme: a literature review and case report","volume":"34","author":"Kempton J","year":"2012","journal-title":"Pediatr Dent"},{"key":"e_1_2_9_5_1","first-page":"359","article-title":"Herpes simplex\u2010associated erythema multiforme (HAEM): a clinical therapeutic dilemma","volume":"21","author":"Katz J","year":"1999","journal-title":"Pediatr 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