Page 1114 - Problem-Based Feline Medicine

1106 PART 13 CAT WITH SKIN PROBLEMS

Toxic epidermal necrolysis is associated with sys- Differential diagnosis
temic signs including pyrexia, depression, anorexia.
Other vesicular and pustular disorders, e.g. bacterial
infections, pemphigus foliaceous, burns, chemical der-
Diagnosis matitis need to be ruled out.
A presumptive diagnosis is based on the clinical
Treatment
appearance of an acute ulcerative condition
involving the skin and mucous membranes, which Cyclosporin 5 mg/kg PO q 24 h. Not registered for use
is associated with a recent history of drug adminis- in cats.
tration. Other differential diagnoses need to be
Remove drug or diet triggers if identified.
excluded.
Supportive treatment (intravenous fluids, warmth,
Histopathological examination of erythematous
avoidance of sepsis) needed where large amounts of
macules or ulcer margins reveals epidermal changes
epithelium are lost.
including hydropic degeneration, prominent single
cell to apoptosis, lymphocyte and macrophage satelli-
Prognosis
tosis and variable dermal edema (EM) to full thick-
ness epidermal necrosis (TEN). Inflammatory Prognosis is good if the trigger can be removed and the
changes in the dermis are mild to marked in EM but area affected is small, but is poor where large areas of
often absent in TEN. epidermis have been lost.

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