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Abstract Infection of the footpad epidermis can occur in natural canine distemper virus (CDV) infection of
dogs. Footpads from 19 dogs experimentally inoculated with virulent distemper strain A75/17 and from two nonexposed dogs were examined histopathologically and assessed for the presence of viral antigen and nucleoprotein
mRNA, as well as number of inflammatory and apoptotic cells. Dogs were divided into four groups based on
inoculation status and postmortem examination: inoculated dogs with severe distemper (group 1, n = 7); inoculated
dogs with mild distemper (group 2, n = 4); inoculated dogs without distemper (group 3, n = 8); and noninoculated
dogs (group 4, n = 2). Footpads from dogs of all groups had a comparably thick epidermis. Eosinophilic viral
inclusions and syncytial cells were present in footpad epidermis of one dog of group 1. Footpads of group 1 dogs
contained viral antigen and mRNA in the epidermis with strongest staining in a subcorneal location. Additionally, in these dogs footpad dermal structures including eccrine glands and vascular walls were positive for virus
particles. No CDV antigen or mRNA was present in the footpad epidermis and dermis of any other dog. Group
1 dogs had more CD3-positive cells and apoptotic cells within the basal layer of the epidermis when compared
to the other groups. These findings demonstrate that in experimental infection CDV antigen and mRNA were
colocalized in all layers of the infected canine footpad epidermis. The scarcity of overt pathological reactions with
absence of keratinocyte degeneration indicates a noncytocidal persisting infection of footpad keratinocytes by CDV.
Keywords: canine distemper, dog, footpad, keratinocyte.
IN TRO D U CT I ON
Canine distemper virus (CDV), a morbillivirus, often
causes fatal disease in a variety of terrestrial mammals.1 Usually the gastrointestinal and respiratory
tracts are affected with or without involvement of the
nervous system.2 Infection of epidermal cells by CDV
or related morbilliviruses has been reported in different
species.37 Distemper in dogs is associated with a
vesiculo-pustular dermatitis of varying frequency.8
Another well known sequel, so-called hard pad disease,
is hyperkeratosis of the footpad.9 Involvement of the
footpad epidermis has been suggested to be common
in CDV infection and demonstration of viral antigen
has been proposed as an antemortem diagnosis.10
Changes in the footpad epidermis caused by CDV are
described as proliferation of basal keratinocytes and
orthokeratotic and parakeratotic hyperkeratosis, with
eosinophilic cytoplasmic inclusion bodies and vacuolar degeneration.11 However, in a study of dogs naturally infected with distemper virus, histopathological
changes in the footpad epidermis differed from this
description as neither inclusion bodies nor keratinocyte degeneration were significant characteristics.12
Histopathological evaluation of footpad epidermis from
This work was supported by the Swiss National Science Foundation
(grants #3158657.99 and # 32 61961.00).
Correspondence: A. Grne, Institut fr Pathologie, Tierrztliche
Hochschule Hannover, Bnteweg 17, 30559 Hannover, Germany.
E-mail: agroene@tiho-hannover.de
2004 European Society of Veterinary Dermatology
experimentally infected dogs yielded similar observations. The objective of this work was to analyse and
compare the localization of CDV antigen and mRNA
in these footpads. Additionally, inflammation and
apoptotic cells were characterized, counted, and correlated with presence of CDV antigen and mRNA.
M AT E R IA L S A N D M E T H O D S
The study population consisted of 21 juvenile,
5 month-old, specific pathogen-free Swiss beagle dogs
(11 male, 10 female), which were maintained according
to the guidelines of the institutions animal care and
use committee. Nineteen dogs (nos. 119) were inoculated with the virulent A75/17 CDV strain, which had
been propagated previously in dogs.13 Splenic extracts
(0.2 mL) from these dogs were inoculated via the vena
cephalica antibrachii. Dogs 20 and 21 were noninoculated animals originating from the same supplier.
Animals were monitored daily for clinical signs of
distemper. Any dog showing a decline in body condition or neurological signs was euthanized immediately.
All remaining dogs were euthanized with barbiturate
2036 days post inoculation and necropsied (Table 1).
Samples of body organs (brain, lung, stomach, kidney,
liver, heart, lymphatic organs, urinary bladder, intestinal tract and eyelids) were immersed and fixed in 4%
paraformaldehyde for 24 h, paraffin embedded and
cut. Sections were stained with haematoxylin and eosin
(H&E) for routine histopathology. Presence and
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A Grne et al.
Table 1. Number of dogs, days between inoculation and euthanasia, frequency of inclusions in various body organs, presence of CNS lesions
and presence of CDV in footpad epidermis in 21 beagle dogs after experimental inoculation with virulent A75/17 distemper virus
Viral inclusions
Group
Dog no.
Euthanasia
p.i. (days)
Lung
Stomach
Renal pelvic
epithelium
Urinary
bladder
1
1
1
1
1
1
1
2
3
4
5
6
20
24
24
28
28
32
Few
Few
Few
Few
Many
Few
None
Many
Many
Many
Many
Few
Many
Many
Many
Many
Few
None
Many
Many
Many
Many
Few
None
32
Few
Many
None
Few
31
31
33
33
3336
NA
Few
Few
Few
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
Few
None
None
None
None
2
2
2
2
3
4
8
9
10
11
1219
2021
Other organs
None
IT
Spleen, testis
Pancreas, IT
IT
Bile ducts,
meibomian glands
Tonsil, salivary
gland epithelium
IT
None
None
tonsil
None
None
CNS
lesions
CDV
(footpad epidermis)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
IT, intestinal tract; NA, not applicable, as dogs were not inoculated.
2004 European Society of Veterinary Dermatology, Veterinary Dermatology, 15, 159 167
161
RESU LTS
Severe distemper was diagnosed in seven dogs (group
1) at postmortem examination (Table 1). These dogs
had many viral inclusion bodies in multiple organs
including lung, kidney, stomach and urinary bladder.
Additionally, these dogs had changes in the central
nervous system (CNS) typical for distemper (demyelination, inclusion bodies, astrocytosis). Four inoculated
dogs had mild distemper with individual inclusion
bodies in only one or two body organs (group 2). In
these dogs no changes indicative of distemper were
present in the CNS. Distemper was not diagnosed in
the remaining inoculated dogs (group 3) and was also
not present in the noninoculated dogs (group 4).
On histopathology, there was no apparent difference
in the thickness of the footpad epidermis, including the
stratum corneum, between the four groups of dogs.
Viral inclusion bodies were present in the footpad
epidermis of one dog of group 1 (Fig. 1). They were
located in the cytoplasm and nuclei of individual
keratinocytes in the stratum spinosum. Some of these
cells formed syncytia with multiple nuclei. Individual
keratinocytes exhibited vacuolar degeneration. Footpad
epidermis of some dogs had foci of degenerate or
necrotic keratinocytes. These foci were usually located
either at the epidermal-dermal junction or in the lower
layers of the epidermis. Such foci were more frequently
observed in footpads of group 1 dogs, and less commonly
or absent in footpads of the remaining dogs. The footpads
of most dogs of all groups occasionally had a mild perivascular infiltrate mainly composed of lymphocytes.
Viral antigen was consistently detected in keratinocytes of the suprabasal and subcorneal epidermal layers
of dogs 17 (Table 2). CDV nucleoprotein was present
in the vast majority of keratinocytes in these epidermal
layers and only rarely was viral antigen distributed in a
multifocal pattern (Fig. 2a). In dogs 2, 4 and 5, CDV
antigen was additionally observed in basal keratinocytes (Fig. 2b). There was distinct variation in staining
intensity. Strongest staining was present in the subcorneal layer (for details of distribution and intensity
see Table 2). In all dogs with CDV-positive footpads
CDV antigen was present in the endothelium and
Table 2. Intensity and distribution of CDV nucleoprotein and nucleoprotein mRNA in subcorneal, suprabasal, and basal layers of canine
footpad epidermis
Group 1
1
Nucleoprotein
Subcorneal
+
Suprabasal
+
Basal
Nucleoprotein mRNA
Subcorneal
+++
Suprabasal
+
Basal
Groups 24
2
821
++
+
+
++
+
+++
+
+
+++
+
+
+ +
+
+++
+
++
+
+
++
+
+++
+
+
+++
+
+
+
+
+++
+
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A Grne et al.
2004 European Society of Veterinary Dermatology, Veterinary Dermatology, 15, 159 167
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A Grne et al.
D ISCU SSIO N
Thickening of canine footpad epidermis in association
with an encephalitis (later identified as distemper) was
first described by MacIntyre et al. (1948), and this disease complex was named hard pad disease.22 Similar
footpad lesions are reported to be seen in other diseases such as zinc-responsive dermatosis or pemphigus
foliaceus, and this may be one of the reasons why the
term hard pad disease is currently not used frequently.9 Histologically, this change is consistently
described as massive hyperkeratosis of the footpad epidermis.11,22 Additional features seen in CDV-infected
footpad epidermis include vacuolar degeneration of
keratinocytes, with formation of intracytoplasmic and
intranuclear inclusion bodies.11 These changes were
partly or totally absent in experimentally CDV-infected
2004 European Society of Veterinary Dermatology, Veterinary Dermatology, 15, 159 167
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A Grne et al.
ACKN OWLEDGE ME NT S
The authors thank the Berna Biotech AG, Berne, Switzerland, for financial support, Ines Schmid and Marianne
Wyder for excellent technical assistance, and especially
Claudia von Tscharner for critical review of this
manuscript.
R E FEREN CES
1. Deem SL, Spelman LH, Yates RA et al. Canine distemper in terrestrial carnivores: a review. Journal of Zoo
Wildlife Medicine 2000; 31: 44151.
2. Alldinger S, Baumgrtner W, Van Moll P et al. In vivo
and in vitro expression of canine distemper viral proteins
in dogs and non-domestic carnivores. Archive of Virology 1993; 132: 421 8.
3. Blixenkrone-Mller M. Detection of intracellular canine
distemper virus antigen in mink inoculated with an
attenuated or a virulent strain of canine distemper virus.
American Journal of Veterinary Research 1989; 50: 161620.
4. Evermann JF, Leathers CW, Gorham JR et al. Pathogenesis of two strains of lion (Panthera leo) morbillivirus
in ferrets (Mustela putorius furo). Veterinary Pathology
2001; 38: 31116.
5. Machida N, Kiryu K, Oh-ishi K et al. Pathology and
epidemiology of canine distemper in raccoon dogs (Nyctereutes procyonoides). Journal of Comparative Pathology 1993; 108: 38392.
6. Lipscomb TP, Mense MG, Habecker PL et al. Morbillivirus
dermatitis in seals. Veterinary Pathology 2001; 38: 7246.
7. McNutt NS, Kindel S, Lugo J. Cutaneous manifestations of measles in AIDS. Journal of Cutaneous Pathology 1992; 19: 31524.
8. Maeda H, Ozaki K, Takagi Y et al. Distemper skin
lesions in a dog. Zentralblatt fr Veterinrmedizin [A]
1994; 41: 24750.
9. Yager JA, Wilcock BP, eds. Color Atlas and Text of
Surgical Pathology of the Dog and Cat. London: Wolfe
Publishing, 1994.
10. Haines DM, Martin KM, Chelack BJ et al. Immunohistochemical detection of canine distemper virus in haired
skin, nasal mucosa, and footpad epithelium: a method
for antemortem diagnosis of infection. Journal of Veterinary Diagnostic Investigation 1999; 11: 396 9.
11. Lauder IM, Martin WB, Gordon EB et al. A survey of
canine distemper, Part II. Pathology. Veterinary Record
1954; 66: 623 30.
12. Grne A, Groeters S, Koutinas A et al. Non-cytocidal
infection of keratinocytes by canine distemper virus in
the so-called hard pad disease of canine distemper. Veterinary Microbiology 2003; 96: 157 63.
13. Cherpillod P, Tipold A, Griot-Wenk ME et al. DNA
vaccine encoding nucleocapsid and surface proteins of
wild type canine distemper virus protects in natural host
against distemper. Vaccine 2000; 18: 292736.
14. Bollo E, Zurbriggen A, Vandevelde M et al. Canine distemper virus clearance in chronic inflammatory demyelination. Acta Neuropathologica 1986; 72: 69 73.
2004 European Society of Veterinary Dermatology, Veterinary Dermatology, 15, 159 167
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Rsum Linfection de lpiderme des coussinets par le virus de la maladie de Carr (CDV) peut apparatre dans
lvolution naturelle de cette maladie. Cette tude sest intresse dcrire lexamen histopathologique des coussinets de 19 chiens ayant subi une inoculation exprimentale de la souche A75/17 de maladie de Carrr et de 2
chiens non exposs. Dans tous les cas, la prsence dantigne viral tait recherche, ainsi que lARNm des nucloprotines et le nombre de cellules inflammatoires et apoptotiques. Les chiens ont t diviss en quatre groupes
en fonction de leur statut aprs inoculation et de lexamen autopsique: chiens inoculs prsentant une maladie
de Carr svre (groupe 1, n = 7), chiens inoculs prsentant une maladie de Carr modre (groupe 2, n = 4),
chiens inoculs sans maladie de Carr (groupe 3, n = 8), and chiens non inoculs (groupe 4, n = 2). Les coussinets
des chiens de tous les groupes avaient un piderme pais de taille quivalente. Des inclusions virales osinophiliques et des cellules syncitiales taient prsentes dans lpiderme des coussinets dun chien du groupe 1.
Les coussinets des chiens du groupe 1 contenaient des antignes viraux et de lARNm avec un marquage important en position sous-corne. En outre, chez ces chiens, des structures du derme, notamment les glandes eccrines
et les parois vasculaires, taient positives pour le virus. Aucun antigne viral ou ARNm na t observ pour tous
les autres chiens. Les chiens du groupe 1 prsentaient plus de cellules CD3+ et de cellules apoptotiques dans leur
piderme que les autres groupes. Ces observations dmontrent quen cas dinfectioni exprimentale, les antignes
viraux et lARNm sont localiss dans toutes les couches de lpiderme des coussinets. La pauvret de la raction
inflammatoire associe, avec absence de dgnrescence des kratinocytes montre une infection persistente non
cytolytique des kratinocytes des coussinets par le virus de Carr.
Resumen En la infeccin natural por el virus del moquillo canino (VMC) puede producirse infeccin de la epidermis del almohadilla. Las almohadillas de 19 perros inoculados experimentalmente con la cepa virulenta de
moquillo A75/17 y de dos perros no expuestos fueron evaluadas histopatolgicamente y se valor la presencia
de antgeno vrico y mRNA de nucleoproteina, as como el nmero de clulas inflamatorias y apoptticas. Los
perros fueron divididos en cuatro grupos basados en funcin de si haban recibido inoculacin y del examen postmortem: perros inoculados con moquillo grave (grupo 1, n = 7), perros inoculados con moquillo leve (grupo 2,
n = 4), perros inoculados sin moquillo (grupo 3, n = 8), y perros no-inoculados (grupo 4, n = 2). Las almohadillas
de todos los perros mostraban una epidermis comparativamente gruesa. Se hallaron inclusiones vricas eosinoflicas y clulas sincitiales en la epidermis de la almohadilla de un perro del grupo 1. Las almohadillas de los perros
del grupo 1 contenan antgeno vrico y mRNA en la epidemis con mayor intensidad de tincin a nivel subcorneal.
Adems, en las almohadillas de estos perros, las estructuras drmicas incluyendo las glndulas ecrinas y las paredes vasculares fueron positivas a las partculas vricas. No se encontr VMC ni mRNA en la epidemis de la almohadilla ni en la dermis de ningn otro perro. Los perros del grupo 1 tenan ms clulas CD3-positivas y clulas
apoptticas en la capa basal de la epidermis que los de los dems grupos. Estos hallazgos demuestran que en la
infeccin experimental, el antgeno y mRNA del VMC se encontraban co-localizados en todas las capas de la
epidermis canina de las almohadillas infectadas. La escasez de reacciones histopatolgicas claras con la ausencia
de degeneracin de queratinocitos indica una infeccin persistente no-citocida de los queratinocitos de la almohadilla por parte del VMC.
Zusammenfassung Bei der natrlichen Infektion mit caninem Staupevirus (CSV) kann es bei Hunden zu einer
Infektion der Epidermis der Fusohlen kommen. Die Fusohlen von 19 Hunden, die experimentell mit dem virulenten Staupe-Stamm A75/17 inokuliert wurden und von zwei nicht exponierten Hunden wurden histopathologisch untersucht und in Hinblick sowohl auf das Vorhandensein von viralem Antigen und NukleoproteinmRNA als auch auf die Anzahl von inflammatorischen und apoptotischen Zellen hin berprft. Aufgrund des
Inokulationsstatus und der post-mortem Untersuchung wurden die Hunde in 4 Gruppen eingeteilt: inokulierte
Hunde mit starker Staupe (Gruppe 1, n = 7), inokulierte Hunde mit milder Staupe (Gruppe 2, n = 4), inokulierte
Hunde ohne Staupe (Gruppe 3, n = 8) und nicht inokulierte Hund (Gruppe 4, n = 2). Die Fusohlen der Hunde
aller Gruppen hatten vergleichbar dicke Epidermis. Bei einem Hund der Gruppe 1 waren eosinophile virale Einschlusskrperchen und Synzytialzellen in der Epidermis der Fusohlen vorhanden. Die Fusohlen der Hunde
von Gruppe 1 enthielten virales Antigen und mRNA in der Epidermis mit der strksten Anfrbung in einer subkornealen Lokalisation. Bei den Fusohlen dieser Hunde waren dermale Strukturen einschlielich der eccrinen
Drsen und der Gefwnde positiv fr Viruspartikel. Bei keinem der anderen Hunde war CSV-Antigen oder
mRNA in der Epidermis oder Dermis der Fusohlen vorhanden. Die Hunde der Gruppe 1 hatten im Vergleich
zu den anderen Gruppen mehr CD3-positive und apoptotische Zellen in der Basalschicht der Epidermis. Diese
Ergebnisse zeigen, dass bei experimenteller Infektion CSV-Antigen und mRNA zusammen in allen Schichten der
infizierten caninen Epidermis der Fusohlen zu finden sind. Die Seltenheit offensichtlicher pathologischer Reaktionen zusammen mit dem Fehlen von Keratinozytendegeneration weist auf eine nicht-zytozide persistierende
Infektion der Keratinozyten der Fusohlen durch CSV hin.