Pemphigus Foliaceus

 

The autoimmune disease has primary lesions are superficial pustules, which frequently rupture to form crusts with underlying erosions.

In cats, lesions most frequently develop at or around the nasal planum and muzzle, pinnae (See Figure above, Classic pattern of feline pemphigus foliaceus with adherent crusts around the face, dorsal muzzle, periorbital region, and pinnae). Thickly crusted and erythematous, Excessive scaling of the footpads with crusts adherent to the footpad margins and nails.

Pathophysiology ;

The feline pemphigus foliaceus involves development of autoantibodies, which produce a loss of intercellular adhesion in the upper layers of the stratum corneum (acantholysis). This leads to vesicle and pustule formation. Genetics, drugs and other factors are known triggers for antikeratinocyte autoantibody induction.

Diagnosis; 

Cytologic examination of pustule contents may provide a tentative diagnosis based on the presence of neutrophils and large rounded (acantholytic keratinocytes). However, histopathologic examination of skin biopsy tissues is required for definitive diagnosis. CBC will show leukocytosis with may or may not anisocoria.

Treatment;

The treatment protocol requires immunosuppressive therapy. Although treatment for canine pemphigus foliaceus often requires multidrug protocols but  administration of corticosteroids alone may be successful in most of the cats. I always prefer treatment with dexamethasone in cats (0.22 mg/kg at a tapering dose) as the initial corticosteroid choice. Cephalxin just to reduce secondary bacterial infection ( 25mg/kg).