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Questions and Answers
What is a potential primary agent causing folliculitis in cats with acne?
What severe symptom may develop from cases of folliculitis related to feline acne?
Which of the following treatments should be used with caution in cats due to potential side effects?
In feline acne, what is often observed concurrently with follicular distention?
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What is a potential irritant in topical treatments for acne in cats?
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What could be a consequence of using systemic isotretinoin carelessly?
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What is commonly misidentified as the primary cause of lesions in feline acne?
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What symptom may suggest a chronic or recurrent issue in cats with acne?
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What is the initial treatment for swelling of the chin associated with feline acne?
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Which factor is NOT mentioned as a cause of feline acne?
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What is the recommended approach for managing relapses of feline acne?
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Which of the following statements about systemic isotretinoin is correct?
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What maintenance treatment is suggested for cats predisposed to feline acne?
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Which of the following is NOT a clinical feature associated with severe feline acne?
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In the diagnosis of feline acne, hypersensitivity to which of the following is relevant?
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What type of shampoo is recommended for managing feline acne?
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Which topical treatment is specified as having better penetration for the management of acne?
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What is a common systemic treatment for bacterial infections according to the provided information?
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In severe inflammatory periods, what is the recommended dosage of oral prednisolone?
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Which of the following is not typically used as a topical antibiotic in veterinary dermatology?
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What diagnostic procedure is considered rarely needed but essential in selected cases to characterize changes?
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Which of the following is not mentioned as a cleansing agent for dermatological conditions?
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What kind of culture is indicated for identifying dermatophytosis?
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Which combination topical is mentioned as being specifically effective for acne treatment?
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Study Notes
Overview
- Feline acne is an inflammatory skin condition that affects the chin and lips of cats.
- Symptoms can occur repeatedly or persist for long periods of time.
Causes & Risk Factors
- The exact cause of feline acne is unknown.
- Common associations include allergies, abnormal keratinization, poor grooming, excessive oil production, suppressed immune system, viral infections, and stress.
Signs
- Cats may experience a single episode, recurrent issues throughout their life, or constant symptoms.
- The frequency and severity of each occurrence varies between individuals.
- Symptoms can range from mild to severe including:
- Comedones
- Red papules
- Serous crusts
- Dark keratin debris on the chin and lips
- Chin swelling
- Nodules
- Hemorrhagic crusts
- Pustules
- Cysts
- Fistulae
- Intense redness (erythema)
- Hair loss (alopecia)
- Pain
- Bacterial furunculosis frequently causes pain.
Diagnosis
- Skin scrapings are used to diagnose demodicosis.
- Bacterial cultures are used to identify resistant infections.
- Fungal cultures are used to diagnose dermatophytosis.
- Cytology is used to detect bacteria and Malassezia.
- Biopsies are rarely required and used to characterize changes such as cystic follicles, differentiate acne from other conditions including demodicosis, infections (bacterial, yeast, or fungus), and diagnose neoplasia.
Treatment
- Initial treatment includes:
- Gently clipping hair.
- Soaking the affected areas to soften crusts.
- Food elimination diets can be beneficial.
- Intradermal allergy testing.
- Topical therapies include:
- Shampoos (antiseborrheic)
- Cleansing agents
- Medicated wipes
- Antibiotic ointments
- Other topicals
- Combination topicals
- Topical retinoids
- Systemic therapies include:
- Antibiotics
- Prednisolone
- Isotretinoin
- Cyclosporine
Follow-Up
- Treatment should continue until all lesions have resolved and tapered over 2-3 weeks.
- Monitor for relapses.
- Maintenance cleansing programs minimize relapses; affected cats may develop comedones throughout their lives, which are often cosmetic, and treatment may not be required.
- Recurrent episodes: once the recurrence rate is established, develop an appropriate maintenance protocol for each affected cat.
- Continual episodes: life-long maintenance treatment is necessary.
Medications
-
Shampoos:
- Sulfur-salicylic acid
- Benzoyl peroxide
- Ethyl lactate
-
Cleansing agents:
- Benzoyl peroxide
- Salicylic acid
- Chlorhexidine
- Phytosphingosine
-
Antibiotic ointment:
- Mupirocin 2%
-
Other topicals:
- Clindamycin
- Erythromycin solution or ointment.
-
Combination topicals:
- Benzoyl peroxide-antibiotic gels
-
Topical retinoids:
- Tretinoin (e.g., Retin-A® 0.01%)
-
Systemic antibiotics:
- Amoxicillin with clavulanate
- Cephalosporins
- Fluoroquinolones
Pregnancy, Fertility, and Breeding
- Systemic isotretinoin should not be used in breeding animals.
Contraindications/Possible Interactions
- Benzoyl peroxide and salicylic acids: can be irritating.
- Some wipes contain alcohols: can be irritating.
- Systemic isotretinoin:
- Use with caution if the animal will not allow topical medications.
- Potential side effects on humans (drug interactions and potential teratogenicity).
- The container should be labeled for animal use only to avoid accidental use. It should also be kept separate from human medications.
- Currently difficult to obtain for animal patients.
Miscellaneous
-
Suggested Reading:
- Jazic E, Coyner KS, Loeffler DG, Lewis TP. An evaluation of the clinical, cytological, infectious and histopathological features of feline acne. Vet Dermatol 2006, 17(2):134–140.
- Miller WH, Griffin CE, Campbell KL. Acne. In: Muller & Kirk’s Small Animal Dermatology, 7th ed. St.Louis, MO: Elsevier, 2013, pp. 640–642.
- Rosencrantz WS. The pathogenesis, diagnosis, and management of feline acne. Vet Med 1993, 5:504–512.
- Werner AH, Power HT. Retinoids in veterinary dermatology. Clin Dermatol 1994, 12(4):579–586.
- White SD. Feline acne and results of treatment with mupirocin in an open clinical trial: 25 cases (1994–96). Vet Dermatol 1997, 8:157.
- Author: David D. Duclos
- Consulting Editor: Alexander H. Werner, Resnick
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