Section: Overview
Pemphigus foliaceus is a severe skin disease that is characterized by pustules and blisters that rupture, causing damage to the skin of the face, ears, feet and eventually the entire skin.
This disease results when the animal recognizes a specific component of his own skin (desmoglein I) as foreign and makes antibodies against that component. Desmoglein I is important in attaching skin cells to each other. Lack of this component causes the outer layer of the skin to split apart and fill with fluid and cells leading to a blister or pustule. This abnormality of the immune system is an example of an autoimmune disorder.
Middle aged to older cats are more prone to this disease. This disease has a severe health impact on the animal and can be fatal if not treated aggressively.
What to Watch For
Blisters and pustules that rupture and crust over beginning on the face and ears, and progress to the legs, feet, and eventually the entire body.
These animals may be very ill in advanced stages of the disease, and may refuse to eat.
Diagnosis
This disease is confirmed by skin biopsy, preferably of an intact pustule. It is important that a pathologist skilled in reading veterinary skin histopathology read the biopsy.
Your veterinarian may puncture an intact pustule and collect the contents to put on a microscope slide for cytology (microscopic exam of the cells). This test may lead to a preliminary diagnosis that must be confirmed by biopsy. This test also helps to rule out other pustular skin diseases like pyoderma.
Treatment
Immunosuppressive drugs. Since this disease is caused by an abnormality in the immune system, the immune system must be suppressed to treat the problem. Corticosteroids like prednisone are used at high doses for this reason. Although these drugs have the benefit of rapid suppression of the immune system, they have numerous side effects if used at this dosage long-term.
Once the disease is successfully in remission, other immunosuppressive drugs like azathioprine in cats may be used to help lower the dose of corticosteroids needed.
Chrysotherapy. Injections of gold salts have been successful as an aid in treatment.
Antibiotics. These may be needed if the skin is secondarily infected with bacteria.
Topical steroids. If diagnosed early in the disease course, topical steroids may provide temporary relief.
Home Care and Prevention
Give all medications as directed. Follow up appointments with your veterinarian are critical to allow for adjustment of drug dosages to maximize efficacy and minimize side effects.
There is no known way to prevent the development of this disease.
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