skin lesions

Question
I have a 5 year old Belgian Malinois who began losing the pigment in her nose about 9 months ago.  She also began to develop small lesions on the skin on her back which scabbed over and then went away but new ones continued to develop.  Her condition has worstened to the point that the lesions are more numerous and are quarter to half-dollar in size.  Additionally, she is losing pigmentation in the fur on her face, lesions are developing at the corners of her mouth, and her toenails are also losing pigmentation going from black to white.

She has had 3 cruciate ligament repairs in the last two years.  I asked my vet if her condition could be caused by a reaction to the materials used in the surgery.  He thinks not and believes it is some sort of autoimmune disease.  He tried to treat her with cortisone injections and ointments but it makes her urinate uncontrollably.  Her appetite is good and her activity level also remains normal.  Currently the only treatment our vet has recommended is to put an antibiotic cream such as Bacitracin the lesions.  Any suggestions?  

Answer
This could be an autoimmune disease called pemphigus.  You would need a skin biopsy to confirm that diagnosis.  If your dog cannot tolerate steroids, there are other immunosuppressive drugs like clorambucil and gold salts that can be used.  Ask your vet if these may be appropriate.