atypical feline eosinophilic plaque: a case report on the back

Feline eosinophilic plaque (fep) is a subset of eosinophilic granuloma complex which is all characterized by focal or multifocal infiltrates with a consistent clinical presentation. they include:1- eosinophilic granuloma؛ mostly occurs on the face and upper lip2- indolent (rodent) ulcer؛ often appears in the oral cavity3- eosinophilic plaque؛ as bald patches not a granuloma or ulcer usually develops on the abdomen and thigh.these lesions occur most often in cats and horses. the pathogenesis of this syndrome is poorly understood, but the most likely cause is a hypersensitivity reaction to insects, food, or environmental allergens. moreover, suspected causes of fep include bacterial infections, autoimmunity and feline herpesvirus-1. histopathology is needed to confirm the diagnosis and rule out other differential diagnoses of similar clinical appearance. it manifests as a perivascular to interstitial to diffuse eosinophilic exudate accompanied by lymphocytes and plasma cells. on march 24th, 2024, a three-year-old female dsh cat was referred to the middle east veterinary hospital complaining of an old pruriginous alopecic wound on her back. the blood panel showed leukopenia. the macroscopic features of the lesion looked like a red warm area and the microscopic view showed an infiltration of lymphocytes, plasma cells, neutrophils and macrophages in the dermis layer. the infiltration was extended to the hypodermic layer, but the epidermis was almost normal. these findings confirmed a chronic fep. current multimodal therapeutic approach includes accurately diagnosing, treating, and managing this condition thereby improving affected cats quality of life. these can consist of hypoallergenic diet trial, ectoparasites treatment, systemic steroids and antimicrobials. in the recent case, a combination of antibiotics, prednisolone and diet change led to treatment and recovery.