Feline Medicine Q&A 02

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A 6-year-old neutered male DSH cat presents with crusting lesions around the mouth, ears, ventral abdomen, and nail beds. Histopathology reveals subcorneal pustules with acantholytic keratinocytes.

Question	Answer		Article
What is this disease?	The clinical signs and histopathology in this cat are typical of pemphigus foliaceous.		[[|Link to Article]]
What is its cause and how should it be treated?	Pemphigus foliaceous is an autoimmune skin disease with deposition of autoantibodies in the epidermis targeted against intercellular adhesion molecules (cadherin desmosomal glycoproteins) causing loss of cellular adhesion. Pemphigus foliaceous lesions most commonly affect the nose and ears, but lesions may be more generalized and affect the nail beds and foot pads. The primary lesions are vesicles, bullae, or pustules. However, these are relatively superficial in the epidermis and are very fragile, so are rarely seen. Erosions and ulcers with crusting and exudation are therefore the common signs. Cytology of exudate may be helpful diagnostically as it may reveal the rounded acantholytic keratinocytes typical of the disease, and immunofluorescence can be used to demonstrate the deposition of antibodies in the lesions.		[[|Link to Article]]
What is the prognosis for the cat?	The prognosis for pemphigus foliaceous is good with most cases responding well to immunosuppressive therapy, although prolonged and sometimes life-long therapy may be required. Glucocorticoids are the treatment of choice (e.g. 2–4 mg/kg/day oral prednisolone, followed by a reducing dose when in remission). If glucocorticoid-sparing therapy is needed, chlorambucil often produces good results.		[[|Link to Article]]