Overview of Feline Contact Dermatitis
Contact dermatitis is an uncommon skin disease of dogs and cats caused by contact with plants (especially plants of the wandering Jew family), medications, and various chemicals. Contact dermatitis is not as common in animals as in people because the skin is protected by their hair coat. Contact dermatitis can develop, however, in areas of the body where the hair is sparse.
Below is an overview of Contact Dermatitis in Cats followed by in-depth information about the diagnosis and treatment of this condition.
Contact dermatitis can be of two different types: allergic or irritant.
Contact allergy is a delayed reaction with signs occurring 24 to 48 hours after contact with the offending substance. The reaction is the same type that occurs in people who develop poison ivy.
Typical signs of contact allergy include pruritus (itchiness) and a papular eruption (red bumps). Pruritus can be severe. The paws and muzzle commonly are affected in animals, and sometimes, the insides of the ears are affected. In households with several animals, it is uncommon for more than one animal to develop an allergic reaction.
Irritant reactions are more painful than pruritic. Small vesicles (blisters) and ulcerations develop. The distribution of the lesions depends on the nature of the offending substance and the pattern of contact.
Secondary bacterial skin infections may develop due to trauma and inflammation.
What to Watch For
Diagnosis of Contact Dermatitis in Cats
Treatment of Contact Dermatitis in Cats
The treatment is to remove the cat from the offending substance.
If contact allergy is suspected, you may asked to confine your animal to a limited area of his normal environment to prevent contact with suspected substances. Confinement should start after a thorough bath, because small particles of the substance may remain on the skin and perpetuate clinical signs.
Compliance is very important. If plants are suspected your cat should stay indoors.
Bacterial skin infections occur commonly in cats with contact allergy or irritant reactions. You may be asked to administer an antibiotic for a minimum of three to four weeks.
In severe cases, a course of anti-inflammatory medications such as prednisone may be necessary to make your pet more comfortable. Orally administered medications usually are safer than injectable preparations and should be used as a first choice. Adverse effects of this type of therapy include increased appetite, increased thirst and increased urinations. Avoidance of the offending allergen should be attempted whenever possible, because corticosteroids tend to lose their efficacy with repeated use. This is called tachyphylaxis.
In-depth information on Contact Dermatitis in Cats
Contact allergy is an immunologic reaction called type IV hypersensitivity in which lymphocytes are the predominant cell type. Contact dermatitis can be either allergic or irritant. Irritant contact dermatitis is not immunologically mediated. Allergens called haptens, which are responsible for contact allergy, are small molecules that are usually lipid soluble and require binding to larger proteins to become allergenic.
Contact allergy involves two different phases: a sensitization phase and an elicitation phase.
Irritant reactions are not immunologically mediated and do not require a sensitization phase. The occurrence of a reaction in a control animal can be used to differentiate between irritant and allergic contact reactions.
A sensitization phase is required before clinical signs develop. This phase seems to vary from six months to two years. During exposure to the hapten, the immune system becomes sensitized to the substance but an allergic reaction is not elicited.
The hapten is taken up by specialized skin cells called Langerhans cells, modified, and presented on the surface of the cell along with major histocompatibility complex (MHC) class II antigens for presentation to T-lymphocytes. The MHC antigens normally distinguish individuals from one another and are evaluated in procedures such as tissue typing. T-lymphocytes are cells that play a key role in the immunologic process.
Antigen presentation occurs in the local lymph nodes. The T-lymphocytes become activated and proliferate, producing a clone of memory T-cells. The existence of a lag phase before the development of clinical signs is an important piece of information for the clinician. This information helps differentiate allergic and irritant contact reactions because clinical signs and microscopic pathology can be similar in these two disorders.
When this hapten is encountered by Langerhans cells it is presented to memory T-cells. These cells secrete chemicals called interleukin-2 (IL-2) and gamma-interferon which stimulate T-cell proliferation and the expression of special adhesion molecules on the surface of skin cells called keratinocytes. These molecules are responsible for the accumulation of inflammatory cells called mononuclear cells in the epidermis.
Inflammatory mediators (eicosanoids, tumor necrosis factor, histamine, interleukins) released by stimulated skin cells (keratinocytes) and specialized inflammatory cells of the skin (mast cells and basophils) are responsible for the redness, dilation of blood vessels and itchiness that occur in allergic contact reactions. Recent studies have focused on the clinical relevance of tumor necrosis factor in natural and experimentally-induced contact allergy.
Contact allergy is uncommon in animals due to protection of the skin by the hair coat. Detergents, waxes, cleansing agents, dyes, deodorants, shampoos, dips, insecticides, corticosteroids, antibiotics, and plants can cause allergic contact dermatitis.
Several plants have been documented to cause contact allergy. These include dandelion leaves, cedar wood, Asian jasmine and wandering Jew. Plants of the Commelinceae family, such as doveweed, spreading dayflower and wandering Jew, are frequently responsible for contact allergy in the southeastern United States. Common characteristics of these plants are lance-shaped fleshy leaves with closed sheaths and a few soft hairs on the upper margin. They reproduce by seed and have blue to purple flowers. They are found in moist habitats and in warm climates and are not usually responsible for contact hypersensitivity in people. Calcium oxalate crystals are hypothesized to be responsible for the allergy-producing effect of these plants.
Related Symptoms or Ailments in Clinical Presentation
Papules, pustules and pruritus persist after resolution of the secondary bacterial infection. The muzzle and paws also are commonly affected. Pruritus varies in severity and may be very intense. It is usually responsive to cortisone-like medications (corticosteroids), at least initially.
Specialized devices called Finn chambers may be used to apply the suspected allergen. A positive reaction is indicated by the appearance of edema (soft swelling) and a papular eruption (red bumps) 24 to 48 hours after application of the allergen.
Complete resolution of clinical signs usually is obtained after 10 to 14 days of avoidance of the offending substance. No prevention is possible unless the offending substance has previously been identified.