Cutaneous Lymphocytic-Plasmacytic Dermatitis in Cats: Causes, Symptoms, Diagnosis, and Treatment
Cutaneous Lymphocytic-Plasmacytic Dermatitis in Cats: Causes, Symptoms, Diagnosis, and Treatment
Cutaneous lymphocytic-plasmacytic dermatitis (CLPD) is a rare skin disease in cats characterized by an infiltration of the dermis with predominantly T cells and a smaller number of B cells. While CLPD and cutaneous lymphoma share similarities in clinical presentation and histopathology, there are significant differences in treatment and prognosis, necessitating accurate differentiation.
1. History and Clinical Symptoms
CLPD typically occurs in older cats, with an average age of 12-13 years. There is no specific breed predisposition. Female cats are slightly more prone to the condition than males.
Typical symptoms:
Single or multiple skin lesions, commonly found on the chest, limbs, ears, and back.
Hair loss, redness, scaling, crusting, nodules, and ulcers.
Approximately half of cases exhibit itching.
Disease course characteristics:
Acute onset, followed by slow progression.
Skin lesions may spontaneously resolve but tend to recur.
2. Histopathological Features
Microscopic examination:
Moderate to large numbers of lymphocytes infiltrating the dermis, surrounding blood vessels and hair follicles or diffusely distributed.
Small lymphocytes with deeply staining nuclei and small to moderate amounts of cytoplasm, with nuclear diameters similar to or slightly larger than red blood cells.
A few mitotic figures.
Edema and neovascularization may be present in the dermis.
Localized ulceration of the epidermis with minimal infiltration of neutrophils.
Immunohistochemistry staining:
Majority of lymphocytes are positive for CD3 antibodies, indicating T cell origin.
A few lymphocytes clustered in the deep dermis are positive for PAX5 antibodies, indicating B cell origin.
3. Differential Diagnosis
Differentiation from cutaneous epitheliotropic T cell lymphoma is required.
Characteristics of cutaneous epitheliotropic T cell lymphoma:
Marked epitheliotropism.
Atypical nuclear morphology.
Increased mitotic figures.
Formation of Pautrier’s microabscesses in the epidermis.
4. Diagnosis
Diagnosis is based on the following characteristics:
Clinical signs.
Histopathological examination.
Immunohistochemical staining results.
5. Treatment
Treatment options:
Surgical excision of single lesions.
Topical or systemic corticosteroid therapy.
Treatment response:
Response to treatment varies among patients.
Recurrence may occur after surgical excision.
Corticosteroid therapy may require the use of other drugs, such as chlorambucil or lomustine.
6. Prognosis
CLPD is a slowly progressive, benign disease.
Skin lesions may wax and wane or remain stable without worsening.
A few cases may progress, developing ascites, lymph node enlargement, and multi-organ lymphocyte infiltration, ultimately requiring euthanasia.
7. Takeaways
CLPD is a relatively rare feline skin disease that is usually benign, but there is a risk of progression. Early diagnosis and prompt treatment are essential for controlling disease progression.
Observe your cat's skin for any abnormalities and seek veterinary attention for diagnosis.
Follow your veterinarian's treatment recommendations and schedule regular checkups.
Educate yourself about feline skin diseases to better care for your cat.
Cutaneous lymphocytic-plasmacytic dermatitis (CLPD) is a rare skin disease in cats characterized by an infiltration of the dermis with predominantly T cells and a smaller number of B cells. While CLPD and cutaneous lymphoma share similarities in clinical presentation and histopathology, there are significant differences in treatment and prognosis, necessitating accurate differentiation.
1. History and Clinical Symptoms
CLPD typically occurs in older cats, with an average age of 12-13 years. There is no specific breed predisposition. Female cats are slightly more prone to the condition than males.
Typical symptoms:
Single or multiple skin lesions, commonly found on the chest, limbs, ears, and back.
Hair loss, redness, scaling, crusting, nodules, and ulcers.
Approximately half of cases exhibit itching.
Disease course characteristics:
Acute onset, followed by slow progression.
Skin lesions may spontaneously resolve but tend to recur.
2. Histopathological Features
Microscopic examination:
Moderate to large numbers of lymphocytes infiltrating the dermis, surrounding blood vessels and hair follicles or diffusely distributed.
Small lymphocytes with deeply staining nuclei and small to moderate amounts of cytoplasm, with nuclear diameters similar to or slightly larger than red blood cells.
A few mitotic figures.
Edema and neovascularization may be present in the dermis.
Localized ulceration of the epidermis with minimal infiltration of neutrophils.
Immunohistochemistry staining:
Majority of lymphocytes are positive for CD3 antibodies, indicating T cell origin.
A few lymphocytes clustered in the deep dermis are positive for PAX5 antibodies, indicating B cell origin.
3. Differential Diagnosis
Differentiation from cutaneous epitheliotropic T cell lymphoma is required.
Characteristics of cutaneous epitheliotropic T cell lymphoma:
Marked epitheliotropism.
Atypical nuclear morphology.
Increased mitotic figures.
Formation of Pautrier’s microabscesses in the epidermis.
4. Diagnosis
Diagnosis is based on the following characteristics:
Clinical signs.
Histopathological examination.
Immunohistochemical staining results.
5. Treatment
Treatment options:
Surgical excision of single lesions.
Topical or systemic corticosteroid therapy.
Treatment response:
Response to treatment varies among patients.
Recurrence may occur after surgical excision.
Corticosteroid therapy may require the use of other drugs, such as chlorambucil or lomustine.
6. Prognosis
CLPD is a slowly progressive, benign disease.
Skin lesions may wax and wane or remain stable without worsening.
A few cases may progress, developing ascites, lymph node enlargement, and multi-organ lymphocyte infiltration, ultimately requiring euthanasia.
7. Takeaways
CLPD is a relatively rare feline skin disease that is usually benign, but there is a risk of progression. Early diagnosis and prompt treatment are essential for controlling disease progression.
Observe your cat's skin for any abnormalities and seek veterinary attention for diagnosis.
Follow your veterinarian's treatment recommendations and schedule regular checkups.
Educate yourself about feline skin diseases to better care for your cat.
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