Feline acne in Cats (Felis) | Vetlexicon
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Feline acne

ISSN 2398-2950

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Introduction

  • Acne is a common idiopathic dermatosis of follicular keratinization.
  • Signs: the chin is the usual site with the upper and lower lips less commonly affected.
  • Most affected cats have only mild lesions-comedones but some may progress to have:
    • Papules.
    • Pustules.
    • Furunculosis.
    • Cellulitis.
    • Cysts.
    • Scarring.
  • Diagnosis: examination and histopathology.
  • Treatment: topical agents, systemic antibiotics, occasionally other drugs.
  • Prognosis: some cats can be cured but many require long-term treatment for recurrent disease.
    Print off the owner factsheet on Feline acne  Feline acne  to give to your client.

Presenting signs

  • Comedones on the chin.
  • Comedones on the lips.
  • Secondary pyoderma.
  • Severe deep pyoderma with systemic signs.

Acute presentation

  • Anorexia, depression, pyrexia found with deep pyoderma.
    Concurrent immunosuppression should be ruled out.

Age predisposition

  • Possibly more common when older but occurs at all ages.

Cost considerations

  • For cases presenting with the most severe signs.
  • Most cases.

Pathogenesis

Etiology

  • Some factors have been recorded as possible underlying factors:
    • Decreased grooming.
    • Food soiling.
    • Genetics.
    • Stress.
    • Viruses.
    • Immunosuppression.

Predisposing factors

General

  • Immunosuppression may lead to deep pyoderma.

Pathophysiology

  • Idiopathic keratinization disorder.
  • Unknown factors   →   dilated hair follicle containing sebaceous material and cornified cells (comedo).
  • Secondary bacterial colonization   →   folliculitis, furunculosis, cellulitis.

Diagnosis

Presenting problems

  • Papules.
  • Pustules.
  • Comedones.
  • Hypotrichosis.
  • Facial swelling.
  • Depression.
  • Pyrexia.
  • Anorexia.

Client history

  • Incidental finding on routine examination.
  • Swelling or black spots on the chin or lips.
  • Rubbing the chin.
  • Gross chin swelling.
  • Anorexia.
  • Depression.

Clinical signs

  • Comedones on chin.
  • Comedones on lips.
  • Swollen chin.

Diagnostic investigation

Histopathology

  • Skin biopsy  Biopsy: skin  :
    • Comedones.
    • Folliculitis.
    • Furunculosis.

Microbiology

  • Bacteriology:
    • Positive culture from skin swab in cases with concurrent pyoderma.
  • Mycology:
    • Positive dermatophyte culture.

Cytopathology

Confirmation of diagnosis

Discriminatory diagnostic features

  • Signs.

Definitive diagnostic features

  • Histopathology.

Differential diagnosis

Other causes of chin swelling

Other causes of comedones

Treatment

Initial symptomatic treatment

Mild cases

  • Asymptomatic disease: no treatment necessary.
  • Comedones only: cleansing shampoo, surgical spirit.

Severe cases

  • Superficial pyoderma: add antibacterial/anti-Malassezia shampoo and a systemic antibiotic used for pyoderma (cephalexin Cefalexin, clindamycin Clindamycin, clavulanate-potentiated amoxycillin Clavulanate) until the lesions have resolved.
  • See also Therapeutics: skin Therapeutics: skin and Therapeutics: antimicrobials Therapeutics: antimicrobial drug.
  • Deep pyoderma: add hot compresses. Occasionally may need more aggressive supportive care if there is systemic illness.

Monitoring

Mild cases

  • Minimal monitoring for mild disease.

Severe cases

  • Re-examine after 2-3 weeks if pyoderma is present and use antibiotics until lesions resolved.
  • Then treat as mild disease.

Subsequent management

Treatment

  • Use the minimum effective treatment.

Monitoring

  • Owner can detect lesions if recur.

Prevention

Control

  • Many cases require preventative treatment with topical cleansing agents/shampoos or surgical spirit.
  • In recurrent cases topical antibiotic cream or isotretinoin (2 mg/kg/day) can be tried.
  • See also Therapeutics: antibacterials Therapeutics: antimicrobial drug and Therapeutics: skin  Therapeutics: skin.

Outcomes

Prognosis

  • Good: often benign, when more severe should respond to treatment.
  • Often recurs without continued treatment.

Reasons for treatment failure

  • Incorrect diagnosis.
  • Owner unable to medicate effectively.
  • Recurrence due to inability to eliminate underlying causes.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Foil C S (1995) Facial, pedal, and other regional dermatoses. Vet Clin North Amer 25 (4), 923-944 PubMed.
  • Werner A H & Power H T (1994) Retinoids in veterinary dermatology. Clin Dermatol 12 (4), 579-586 PubMed.
  • Rosenkrantz W S (1992) The pathogenesis, diagnosis and management of feline acne. Vet Med 86 (5), 504-12 VetMedResource.

Other sources of information

  • Scott D W, Miller W H and Griffin C E (1995) Small Animal Dermatology. 5th edn. Philadelphia W B Saunders. pp 835-7.