Feline Plasma Cell Pododermatitis

Feline Plasma Cell Pododermatitis
Nicole A. Heinrich DVM DACVD
McKeever Dermatology Clinics
www.mckeevervetderm.com 952-946-0035
Plasmascellpododermatitisisanuncommonimmune-mediateddiseaseaffecting
thepawpadsofcats.Thepathogenesisisunknown,butmaybeahypersensitivity
oranautoimmuneprocess.Itischaracterizedbydenseinfiltrationofplasmacells
intothepads.
Theresultingclinicalsignsareswollenpawpads.Theswellingcanbesubtle
initiallyanddramaticinseverecases.Variablescaling,fissuringandevenerosion
canbepresentaswell.Thepadsmaydevelopapurplehueandthetoesmayspread
inanunusualmannerwhenthecatisbearingweight.
Generally,thisisanon-pruriticcondition,althoughcatsmaylickthepawsdueto
discomfort.Concurrentstomatitishasbeenreported.
Thediagnosisisoftenmadebasedonhistoryandphysicalexam.Askinbiopsy
revealsadiffuseinfiltrateofplasmacells.Serumchemistrymayreveal
hypergammaglobulinemia.
Themaindifferentialdiagnosesinclude:atopicdermatitis,foodallergyand
pemphigusfoliaceus.Allergiestendtobemorepruriticthanplasmacell
pododermatitis.Pemphigustendstobemorepainfulwiththickercrustsonthe
pads.Additionally,theclawfoldstendtoaccumulateacaseous,whitedebrisin
pemphigus.Bothcondtionsusuallyfeatureinterdigitalerythemaasopposedto
plasmacellpododermatitiswheretheinterdigitalskinisrarelyaffected.
Thisconditionisgenerallycontrolled,butnotcured.Catsrequireongoing
medicationtokeepthepawscomfortable.
Treatmentsthataremostofteneffectiveinclude:doxycyclinesuspensionand
modifiedcyclosporine.Doxycyclineisadministeredatadoseof5mg/kgPOq12
hoursfor6to8weeks,thenasneededtocontrolswelling.Oncedailydosingmay
bepossible.Modifiedcyclosporine(Atopicaispreferable)isadministeredatadose
of5mg-7mg/kgPOq24hoursfor6to8weeks,thenasneededtocontrolswelling.
Everyotherdaydosingmaybepossible.
Theprognosisisgood.