This disease has been termed dirty face syndrome by some clinicians. It is a poorly understood condition that is recognised in the Persian breed only, with no clear underlying aetiology, and provides a considerable challenge to the clinician to manage (Bond et al., 2000).
The presenting clinical signs are observed in Persian cats and in an initial case series the age of onset ranged from 4 months to 5 years. The dermato-logical examination reveals black waxy material on the distal portion of the hairs in a symmetrical pattern on the face, particularly on the chin, perioral and periocular areas. There is bilateral erythematous otitis externa with black waxy material in some cases. Pruritus is minimal at the outset and becomes severe in some cases (Plate 6.21).
Differential diagnoses usually considered include ectoparasitism, dermatophytosis, food allergy and herpes infection. Various food trials are usually unhelpful, and evidence for the other differentials is frequently not found. There may be secondary bacterial and yeast infections readily demonstrated with skin cytology. The histological changes in skin biopsies include acanthosis, crusting, hydropic degeneration of basal cells and occasional dyskeratotic keratinocytes including the follicular epithelium. An intense mixed superficial dermal infiltrate accompanies the epidermal changes.
There may be a partial response to topical and systemic antimicrobial therapy, including chlorhexidine and miconazole-based products. Systemic antimicrobials (cephalexin, clavulanic acid plus amoxycillin, enro-floxacin) and ketoconazole (10 mg/kg per day) for up to 21 days maybe useful depending on the results from cytology samples and swabs for culture. Glucocorticoids given orally at initial doses of up to 3 mg/kg may have a palliative effect and some cases also respond to depo-steroid injections. The pruritus can become so severe that euthanasia is the final outcome.
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