病例報告：以Trilostane治療犬禿毛X症

禿毛X症是一種少見且病因尚未完全明瞭的內分泌性皮膚疾病。患犬除了皮膚症狀如全身軀幹對稱性禿毛外，身體健康狀態良好。本病例是1隻3歲未結紮博美公犬，就診時呈現全身性脫毛及軀幹有中等程度的色素沉澱；患犬於1歲即開始出現掉毛現象但無伴隨任何系統性症狀；理學檢查僅發現單側性隱睪。採血進行血液學、血清生化學、血清總甲狀腺素（Total T4）濃度、睪固酮濃度檢驗、ACTH刺激試驗及皮膚生檢。血液及內分泌檢查結果皆正常，首先排除腎上腺皮質機能亢進症及甲狀腺機能低下症。皮膚組織病理學檢查顯示瀰漫性毛囊萎縮伴隨有火焰型毛囊形成及毛囊角質化，配合其他檢查之正常結果，此病例確診為禿毛X症。治療首先將患犬去勢及給予口服褪黑激素（Melatonin）兩個月，症狀並無改善；因此給予口服trilostane（劑量為每犬17毫克，1天1次）2個月，患犬的毛稍微長出且沒有明顯的副作用；第3個月開始將劑量調整為每次30毫克，1天1次。1個月後，患犬的被毛幾乎完全恢復。依作者的瞭解，這是台灣第1例使用trilostane成功治療禿毛X症的病例報告，其診斷及治療方法可提供台灣臨床獸醫師參考。

關鍵字

禿毛X症；犬； Trilostane

並列摘要

Alopecia X is a rare endocrine dermatosis which its pathogenesis still remain unclear. Except for dermatological signs such as symmetrical general trunk alopecia, affected dogs are healthy. In this case, a three-year-old intact male Pomeranian is presented with generalized alopecia and moderate hyperpigmentation on the trunk. The dog began to lose hair since one year old without any systemic clinical sign. Unilateral inguinal crytochidism was found on physical examination. Blood examinations for CBC, biochemistry, serum total T4, testosterone were tested. ACTH stimulation test and skin biopsy were also performed. According to the normal blood examinations, hyperadrenocorticism and hypothyroidism were rule out. Skin histopathological findings showed diffuse follicular atrophy with flame follicles formation and follicular keratosis. The patient was diagnosed as alopecia X based on the normal blood examinations and skin histopathological findings. Castration and administration of melatonin for two months were prescribed. Without obvious improvement, trilostane in dose of 17mg per dog once daily was given for the following two months. Mild response and no perceived side effect were observed, the dosage was increased to 30 mg per dog once daily. The hair regrew in a satisfied state after one month of therapy. To the authors' knowledge, this is the first case of Alopecia X successfully treated with trilostane in Taiwan. It can provide a new alternative therapy and an experience for clinicians.

並列關鍵字

Alopecia X ； Dog ； Trilostane

國際替代計量

病例報告：以Trilostane治療犬禿毛X症

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