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Feline Herpesvirus-1 as This recurrence may present as a striking eosinophilic dermatitis of the face and/or nasal planum (occasionally on the extremities) a differential diagnosis that is easily mistaken by both clinicians and histopathologists for allergic eosinophilic dermatitis or eosinophilic granuloma complex. While the literature indicates pruritus may be moderate for feline facial pruritus to absent (Gross et al., 2005), some cases have marked pruritus and resulting self-mutilation which compounds the clinical confusion with allergic pruritus. This commonly results C&T No. 5245
in a fruitless diagnostic work-up for allergic disease as well as ineffectual and possibly aggravating immunosuppressive Long Green Animal Dermatology Center, P.C.
Histopathology of biopsy specimens reveals a necrotizing eosinophilic dermatitis. Intranuclear viral inclusions may not be present or may be easily missed by the histopathologist. Both PCR and immunohistochemical techniques have been investigated and validated as screening tools for herpetic dermatitis (Hargis et al., 1999, Persico et al., 2011). However, the discovery of the safe and effective use of the human antiviral, Famciclovir, has revolutionized our ability to both diagnose and treat this disease (Thomasy et al., 2006, Malik et al., 2009, Thomasy et al., 2011). The author recommends a 2 to 3 week empirical course of Famciclovir as a diagnostic rule out in cases of feline facial dermatitis and pruritus where herpes may be suspected (125 mg PO BID). In the author’s experience, response is noted in many cases of nebulous feline facial excoriation and dermatitis that were previously misdiagnosed as allergic in etiology and treated unsuccessfully with steroids and/or cyclosporine. The veterinary practitioner should be mindful of this insidious differential diagnosis when confronted with refractory feline facial dermatitis cases.
REFERENCES
Figure 1. Feline herpetic facial dermatitis Gross TL et al., Feline herpesvirus ulcerative dermatitis. In: Skin Diseases of the Dog and Cat. Clinical and Histopathologic Diagnosis, 2nd edition. Oxford: Blackwell Science, 124-126, 2005.
Hargis A.M. et al. Ulcerative facial and nasal dermatitis and stomatitis in cats associated with feline herpesvirus-1. Veterinary Dermatology. 10: 267-74, 1999.
Malik R et al. Treatment of feline herpesvirus-1 associated disease in cats with famciclovir and related drugs. J Feline Med Surg. 11(1): 40-48, 2009.
Persico P et al. Detection of feline herpes virus 1 via polymerase chain reaction and immunohistochemistry in cats with ulcerative facial dermatitis, eosinophilic granuloma complex reaction patterns and mosquito bite hypersensitivity. Veterinary Dermatology. 22: 521-527, 2011.
Thomasy SM et al., Safety and efficacy of famciclovir in cats infected with feline herpesvirus 1. Veterinary Ophthalmology. 6:418, 2006.
Thomasy SM et al. Evaluation of orally administered famciclovir in cats experimentally infected with feline herpesvirus type-1. Am J Vet Res. 72(1): 85-95, 2011.
Figure 2. The patient post treatment Feline patients with allergic disease can present clinically with a reaction pattern known as head and neck pruritus. This We want YOU to enjoy the C&T Series in
severe and most frustrating of feline reaction patterns can complementary e-book format as well as print.
result in dramatic mutilation and is often refractory to numerous treatments. A typical list of differential diagnoses includes: Send CVE your current email address today to ensure parasites (i.e Notoedres, Demodex gatoi, Otodectes) and allergic that you receive the quarterly email with the upload address for the latest C&T Series in e-book format.
disease (Flea allergy, food allergy and atopy). Often overlooked is the possibility of feline herpesvirus ulcerative dermatitis. Contact [email protected] or call Jacqui Feline Herpesvirus-1 (FHV-1) is most commonly associated with Kennedy on (02) 9351 7979 to access your Login and upper-respiratory tract disease, including rhinotracheitis and Password details. Then Visit www.cve.edu.au/candtebook keratoconjunctivitis. Following primary infection, it is harbored in which allows you access to this current issue in e-book the trigeminal ganglion in latency. Following immunosuppression format AND the 4 prior issues (Sept 2011, Dec 2011, or stress, viral replication can reactivate and result in recurrence. 10 Control & Therapy Series – 268 SEPTEMBER 2012
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