PMC5362848_01
Skin nodules measuring 2-10 mm in diameter were distributed on the (a) outer pinnal surfaces and (b) orbital regions. Most of them were observed on the right pinna, where they gathered with coalescing patterns
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Teaching Hospital of the Faculty of Veterinary Medicine, University of Lisbon, with multiple nodular skin lesions (Figure 1), ulcerative dermatitis involving the four limbs (Figure 2) and fever. The cat was referred 1 year after the onset of skin lesions and was previously treated for a presumptive pyodermatitis with prednisolone (1 mg/kg PO q12h for 12 days) and amoxicillin/clavulanic acid (20 mg/kg PO q12h for 6 days), followed by doxycycline (5 mg/kg PO q12h for 8 days), and showed no clinical improvement. About 20-25 skin nodules measuring 2-10 mm in diameter were distributed on the outer pinnal surfaces (Figure 1a) and orbital regions (Figure 1b).
Single spots (between 20 and 50 mm in diameter) of ulcerative dermatitis that had raised margins affecting the (a) antebrachial and (b) hock regions after disinfection of lesions
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Teaching Hospital of the Faculty of Veterinary Medicine, University of Lisbon, with multiple nodular skin lesions (Figure 1), ulcerative dermatitis involving the four limbs (Figure 2) and fever. The cat was referred 1 year after the onset of skin lesions and was previously treated for a presumptive pyodermatitis with prednisolone (1 mg/kg PO q12h for 12 days) and amoxicillin/clavulanic acid (20 mg/kg PO q12h for 6 days), followed by doxycycline (5 mg/kg PO q12h for 8 days), and showed no clinical improvement. Single spots (20-50 mm in diameter) of ulcerative dermatitis, which had raised margins, affected the antebrachial (Figure 2a) and hock (Figure 2b) regions.
Fine-needle aspiration smear of a skin nodule showing many extracellular (small arrows) and intracellular Leishmania amastigotes in the cytoplasm of macrophages (large arrows). Giemsa stain, scale bar = 20 microm
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The smears revealed Leishmania amastigotes (Figure 3), and absence of bacteria/neutrophilic infiltration or characteristic cells of autoimmune diseases.
Cat 18 months after treatment with allopurinol and N-methyl-glucamine antimoniate (Glucantime; Merial), illustrating the absence of skin nodules on the ears and head
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Total remission of skin nodules on the head, as well as the foreleg ulcers, was achieved (Figure 4), with body temperature being normalised on day 45.
Intraoperative images showing the excision of the defect edges in the (a) right and (b) left hindlimb
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Complete closure of the hindlimb ulcerative lesions did not occur owing to an extreme tension in those regions, which required surgery (Figure 5).
Hindlimbs 4 weeks after surgery
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The complete healing of hindlimb lesions was achieved 1 month after surgery (Figure 6).