Page 1330 - Problem-Based Feline Medicine

1322 PART 15 CAT WITH EYE PROBLEMS

Differential diagnosis SOLAR DERMATITIS**

Autoimmune skin disease causes peri-ocular inflam-
mation, alopecia and crusting with sites remote from Classical signs
the eyelid affected as well, for example, ear pinna,
● Erythema and crusting, with or without
muzzle, nasal planum, nailbeds.
hemorrhage.
Allergic skin disease causes swollen inflamed lids, ● Almost always involves non-pigmented
sometimes with conjunctival chemosis and ocular eyelid skin only.
discharge. May respond rapidly to topical anti-inflam-
matory treatment or identification and removal of an
offending antigen from the environment, e.g. stopping Clinical signs
feeding of an allergenic food or reduce exposure to
Erythema and crusting is usually seen, occasionally
insects by enclosure in a gauzed cat house.
associated with hemorrhage under the crusts. The
Infectious eyelid skin diseases respond to treatment lesion is regarded as a precursor to the development
with antibiotics, antifungals or antiparasitics. of squamous cell carcinoma.
Any lesion appearing in pigmented eyelid skin is very Non-pigmented areas only are affected almost with-
unlikely to be squamous cell carcinoma. out exception.
The lesions are more commonly seen on the lower lid
Treatment rather than the upper lid because of the more direct
exposure to UV light.
Wide surgical excision is the treatment of choice for
most neoplastic lesions. Wide excision is especially Associated lesions may be seen on the nasal planum or
important in the treatment of mast cell tumor and squa- the tips of the ears.
mous cell carcinomas as the borders between the
neoplasm and normal tissue can be ill-defined. Large
excisions may require plastic surgery procedures to Diagnosis
replace removed sections of eyelid. As the lower lid is
Tentative diagnosis is based on the appearance of the
more frequently involved, lip-to-lid subdermal plexus
lesions and location in non-pigmented areas of eyelid
flaps can be used. Lid-splitting techniques can be used
skin.
for smaller defects.
Definitive diagnosis is made on the histopathological
Adjunctive modalities can include:
examination of affected eyelid skin.
● Squamous cell carcinoma: cryosurgery, b irradi-
ation.
● Basal cell carcinoma: cryosurgery. DERMATOPHYTOSIS**
● Mast cell tumor: chemotherapy with oral and intrale-
sional steroids. Intralesional injections with hypotonic Classical signs
solutions (sterile distilled water) have also been used as
● Alopecia and crusting or scaling of peri-
an adjunctive therapy. See reference on page 1075 for
ocular eyelid skin.
more details (The Cat With Skin Lumps and Bumps).
● Other similar lesions on the face or ears.
Prognosis
Clinical signs
Varies depending on the type and stage of the neopla-
sia, degree of local tissue and/or systemic involvement. Typical lesions include alopecia and crusting or
scaling of peri-ocular eyelid skin.
The prognosis is grave for cats affected by FeSV-
induced fibrosarcoma. Other similar lesions might be seen on the face or ears.