Acne in Cats - Blackwell's Five-Minute Veterinary Consult PDF

14 Blackwell’s Five-Minute Veterinary Consult A Acne—Cats (bacterial, yeast, or dermatophytes), or to Severe cases may warrant treatment with diag...

14 Blackwell’s Five-Minute Veterinary Consult A Acne—Cats (bacterial, yeast, or dermatophytes), or to Severe cases may warrant treatment with diagnose neoplasia. isotretinoin (Accutane) or cyclosporine, PATHOLOGIC FINDINGS modified (Atopica®). ­ BASICS Demodicosis—isoxazoline parasiticides. Mild disease—follicular distention with OVERVIEW keratin (comedo), hyperkeratosis, and CONTRAINDICATIONS/POSSIBLE Inflammatory dermatitis affecting the chin follicular plugging, most often associated INTERACTIONS and lips. with allergic dermatitis. Benzoyl peroxide and salicylic acids—can Symptoms may be recurrent or persistent. Severe disease—mild to severe folliculitis be irritating. SIGNALMENT and perifolliculitis with follicular pustule Some wipes contain alcohols that can be Cats. formation leading to furunculosis and irritating. Prevalence for sex, age, or breed not pyogranulomatous dermatitis. Systemic isotretinoin—use with caution, if reported. Bacteria and Malassezia in these lesions are animal will not allow application of topical considered secondary invaders and not medications; potential deleterious side effects SIGNS causative agents. in human beings (drug interactions and Cats may have a single episode, a life-long Demodex mites can be primary agents of teratogenicity); container should be labeled recurrent problem, or a continual disease. this disease. for animal use only and kept separate from Frequency and severity of each occurrence vary with the individual. human medications to avoid accidental use; Comedones, mild erythematous papules, currently difficult to obtain for animal serous crusts, and dark keratin debris develop patients. on the chin and less commonly on the lips. ­ TREATMENT Swelling of the chin. Initial treatment—gentle clipping and Severe cases—nodules, hemorrhagic crusts, soakings to soften crusts. pustules, cysts, fistulae, severe erythema, Food elimination diet. ­ FOLLOW-UP alopecia, and pain. Intradermal allergy testing. Monitor for relapses. Pain often associated with bacterial Continue one or a combination of the Maintenance cleansing programs can be furunculosis. therapies listed below until all lesions have used to reduce relapses; affected cats are likely CAUSES & RISK FACTORS resolved. to have variable numbers of comedones Discontinue treatment by tapering life-long, which often are just cosmetic, and Precise etiology unknown; often is associated with allergic skin diseases; may be a disorder medication over a 2- to 3-week period. treatment is not necessary. Recurrent episodes—once the recurrence of keratinization, poor grooming, abnormal sebum production, immunosuppression, viral rate is determined, an appropriate maintenance infection, or stress. protocol can be designed for each individual. Continual episodes—life-long maintenance treatment necessary. ­ MISCELLANEOUS PREGNANCY/FERTILITY/BREEDING Systemic isotretinoin should not be used on ­ DIAGNOSIS breeding animals. DIFFERENTIAL DIAGNOSIS ­ MEDICATIONS ­Suggested Reading Hypersensitivity (atopy, flea bite, food, Jazic E, Coyner KS, Loeffler DG, Lewis TP. contact). DRUG(S) OF CHOICE An evaluation of the clinical, cytological, Bacterial folliculitis. Topical infectious and histopathological features of Demodicosis. Shampoo—once or twice weekly with feline acne. Vet Dermatol 2006, Malassezia infection. antiseborrheic (sulfur-salicylic acid, benzoyl 17(2):134–140. Dermatophytosis. peroxide, or ethyl lactate). Miller WH, Griffin CE, Campbell KL. Acne. Neoplasia of sebaceous or apocrine glands. Cleansing agents—benzoyl peroxide, salicylic In: Muller & Kirk’s Small Animal Eosinophilic granuloma. acid, chlorhexidinephytosphingosine. Dermatology, 7th ed. St. Louis, MO: Medicated wipes. Elsevier, 2013, pp. 640–642. CBC/BIOCHEMISTRY/URINALYSIS Antibiotic ointment—mupirocin 2%. Rosencrantz WS. The pathogenesis, N/A Other topicals—clindamycin or erythro­ diagnosis, and management of feline acne. OTHER LABORATORY TESTS mycin solution or ointment. Vet Med 1993, 5:504–512. N/A Combination topicals—benzoyl peroxide- Werner AH, Power HT. Retinoids in IMAGING antibiotic gels (e.g., Benzamycin). veterinary dermatology. Clin Dermatol N/A Topical retinoids—tretinoin (e.g., Retin-A® 1994, 12(4):579–586. 0.01%): gel more effective because of better White SD. Feline acne and results of DIAGNOSTIC PROCEDURES penetration. Skin scrapings—demodicosis. treatment with mupirocin in an open In severe inflammatory periods 10–14 days clinical trial: 25 cases (1994–96). Vet Bacterial culture—resistant infection. of oral prednisolone (1–2 mg/kg q24h) may Fungal culture—dermatophytosis. Dermatol 1997, 8:157. help to reduce scar tissue formation. Author David D. Duclos Cytology—bacteria, Malassezia. Biopsy—rarely needed; necessary in Systemic Consulting Editor Alexander H. Werner selected cases to characterize changes such as Antibiotics—amoxicillin with clavulanate, Resnick cystic follicles, to differentiate acne from cephalosporin, or fluoroquinolone. other diseases such as demodicosis, infections