(2) UDEAR, Université de Toulouse, INSERM, Toulouse, France
(3) Department of basic sciences, Université de Toulouse, ENVT, Toulouse, France
(4) Clinique vétérinaire, Saint-Céré, France
Jean-paul Moulin (4)
Sophie Correge (4)
Maxence Delverdier (3)
Marie-christine Cadiergues (1)
A 6-years-old neutered female European shorthair was referred for a chronic moderately pruritic, alopecic and exfoliative dermatosis non responsive to antiparasitic, antibiotic or steroidal anti-inflammatory drugs. On presentation, the cat had a troncular alopecia. Skin was covered by small whitish adherent scales especially numerous at face and muzzle. Moderate licking was reported. Differential diagnosis included sebaceous adenitis, dermatophytosis, demodicosis, exfoliative dermatitis associated or not to thymoma, drug reaction, feline immunodeficiency or feline leukemia virus associated dermatosis, epitheliotroic T-cell lymphoma and Malassezia and/or bacterial overgrowth. Bloods were within normal limits, cat was negative for retrovirus and trichograms, skin scrapings, fungal culture, brushing product examination and skin cytology were negative for parasitic/infectious elements. X-rays showed no signs of thymic mass. Skin biopsies showed marked orthokeratotic hyperkeratosis, lymphocytic (CD3+) interface dermatitis and mural folliculitis with absence of sebaceous glands and occasional apoptotic bodies in different epidermal layers consistent, together with the clinical picture, with non-thymoma-associated exfoliative dermatitis syndrome. The cat was started on cyclosporine A (CsA) at 7 mg/kg once daily. Dramatic improvement was observed after 3 weeks. CsA intake was progressively spaced during the following months with resolution of clinical signs. Control skin biopsies showed resolution of the hyperkeratosis, disappearance of inflammatory infiltrate and recovery of some sebaceous glands. T cell infiltration with signs of epidermal cytotoxicity, in the absence of infectious agents or neoplastic process, evokes an immune-mediated process and suggests CsA as the drug of choice. This is the first report showing resolution of these histological features following CsA administration.
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