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Abstract Eight cases of feline plasma cell pododermatitis, collected over a 3-year period, were studied using
histological (haematoxylin and eosin), histochemical (methyl greenpyronin) and immunohistochemical
(antibody against lambda light chains of immunoglobulins) techniques. No sex, breed or age predisposition,
or paw predilection was observed. The disease began as a swelling of the footpads, followed by ulceration.
Histologically, lesions were characterized by the presence of a large number of plasma cells in a predominantly
perivascular pattern. Binucleated plasma cells and mitotic figures were observed. Clinical follow-up for over
1 year revealed total remission of the lesions both after glucocorticoid therapy in four cases, and total surgical
excision in two animals. Follow-up studies were not possible in one case.
Keywords: feline, footpads, plasma cell, pododermatitis.
INTRODUCTION
Biopsies from eight cases of feline plasma cell pododermatitis were collected between 1999 and 2001 at
the Laboratory of Veterinary Pathology of Instituto
de Cincias Biomdicas de Abel Salazar, University of
Porto. Samples were fixed in 10% formalin, dehydrated,
embedded in paraffin wax and three consecutive sections
were cut from each block.
One section was stained with haematoxylin & eosin
(H&E) and the second with methyl greenpyronin, a
stain that allows differentiation between DNA and
RNA. The methyl green dye binds to DNA, giving it a
bluegreen colour, whereas RNA is coloured red with
pyronin.12 The third section was used for immunohistochemistry, performed according to the modified
avidinbiotinperoxidase complex (ABC) method.13
Briefly, sections were dewaxed, rehydrated and then
submitted to proteolytic digestion by immersion in 10%
target retrieval solution (Dako, Denmark) and incubated
in a water bath at 100 C for 20 min. Endogenous
peroxidase activity was blocked by treatment with 0.3%
hydrogen peroxide (Merck, Germany) in methanol
(Merck) for 10 min. Sections were then incubated in a
moist chamber for 20 min with normal rabbit serum
(Dako) diluted 1:5 in bovine serum albumin (BSA;
Sigma, USA), to eliminate nonspecific staining. Excess
serum was removed and the sections were incubated
overnight at 4 C, with a polyclonal antibody against
lambda light chains of immunoglobulins (clone H0070,
Dako), diluted 1:2. Subsequently, slides were incubated
for 30 min with a 1:200 dilution of biotin-labelled
antirabbit secondary antibody (Dako) and then with
the avidinbiotinperoxidase complex (Dako), for a
further 30 min. The colour was developed by incubation
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with diaminobenzidine (Dako) for 7 min. After counterstaining tissue sections with haematoxylin, slides
were mounted in Entellan (Merck). A positive reaction
was indicated by the presence of brown cytoplasmic
staining and a human plasma cell epulis was used as
the positive control.
Clinical follow-up was performed for a minimum of
one year by direct contact with clinicians and/or owners.
RESULTS
In this study no sex, breed or age predilection was
observed (Table 1). The disease affected male (n = 5) as
well as female (n = 3) cats. Six animals were Domestic
Short Hairs and two were Siamese. Although in two
cases the animals ages were not known, all the others
were young adults, with ages ranging from 3 to 7 years
(mean 4.7 years). The lesions affected both hindlimbs
and forelimbs, as well as right and left feet. There was no
evidence of a seasonal predisposition at the beginning
of the disease. Only two animals, one male and one
female (cases 6 and 8), were neutered. One cat was FIV
positive and the remaining seven were not checked for
FIV infection (Table 1).
The lesions began as an asymptomatic, soft, spongy
swelling of single or multiple footpads (Table 1), some
of which regressed spontaneously but recurred periodically. Only when the lesion became ulcerated, having a
bed of friable red granulation tissue (Fig. 1), and causing
pain and lameness, were cats presented for consultation.
Biopsy was performed in six cases and wide surgical
excision was carried out in the other two.
Histological examination revealed no major differences between the eight cases. Footpad structure was
severely distorted due to the presence of an abundant
inflammatory infiltrate extending from the dermis to
the underlying adipose tissue, in a predominantly perivascular pattern (Fig. 2). The infiltrate was composed almost
entirely of mature plasma cells in which a juxtanuclear
pale area, representing the Golgi apparatus, was observed.
The identity of plasma cells was confirmed histochemically using the methyl greenpyronin technique. With
this method, the cytoplasm stained red, because of its
abundant rough endoplasmic reticulum, while the
Table 1. Clinical details of the cats with plasma cell pododermatitis included in this study
Case
Sex
Breed
Age
( years)
Entire female
DSH
2
3
4
5
Entire male
Entire male
Entire male
Entire male
Siamese
DSH
DSH
DSH
3
Unknown
7
Unknown
6
7
8
Neutered male
Entire female
Neutered female
DSH
DSH
Siamese
5
6
3
Location
Metacarpal R
Metatarsal R + L
Metacarpal R + L
Metacarpal R
Metacarpal L
Metacarpal L
Metatarsal R
Metacarpal R
Metatarsal R
Metacarpal L
FIV status
Not checked
Not checked
Positive
Not checked
Not checked
Not checked
Not checked
Not checked
DSH, Domestic Short Hair; R, right paw; L, left paw; PO, orally.
2003 European Society of Veterinary Dermatology, Veterinary Dermatology, 14, 333337
Treatment
Follow-up
period
Unknown
Not available
Surgical excision
Prednisolone 1 mg kg1 day PO
Prednisolone 1 mg kg1 day PO
Prednisolone 2 mg kg1 day PO
1 year
4 years
2.5 year
1 year
Surgical excision
Prednisolone 2 mg kg1 day PO
Prednisolone 4.4 mg kg 1 day PO
1 year
1 year
1 year
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DISCUSSION
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ACKNOWLEDGEMENTS
The authors wish to thank the Clnica Veterinria da
Areosa, Clnica Veterinria de Custias, Clnica Veterinria de Matosinhos, Vetconde and Policlnica Central
de Aveiro for their helpful contribution in collecting
data and for the clinical follow-up.
REFERENCES
1. Gross, T.L., Ihrke, P.J., Walder, E.J. Veterinary Dermatopathology. St. Louis, MO: Mosby Year Book, 1992:
220 1.
2. Medleau, L., Kaswan, R.L., Lorenz, M.D., Dawe, D.L.
Ulcerative pododermatitis in a cat: immunofluorescent
findings and response to chrysotherapy. Journal of the
American Animal Hospital Association 1982; 18: 44951.
3. Scott, D.W., Miller, W.H., Griffin, C.E. Miscellaneous
skin diseases. Small Animal Dermatology, 5th edn.
Philadelphia: WB Saunders, 1995: 906 7.
4. Yager, J.A., Wilcock, B.P. Color Atlas of Surgical Pathology
of the Dog and Cat. London: Mosby Year Book, 1994:
149 50.
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Rsum Huit cas de pododermatite plasmocytes fline, vus sur une priode de 3 ans, ont t tudis par examen
histologique (hmatoxylline et osine), histochimique (methyl green-pyronin) et immunohistochimique
(anticorps contre la chaine lambda des immunglobilines). Aucune prdisposition de sexe, de race ou d'ge n'a
t observe. Aucune localisation de prdilection n'a t observe. La maladie a commenc dans tous les cas par
un gonflement des coussinets, suivi par une ulcration. L'examen histopathologique a montr la prsence de
plasmocytes en grand nombre, principalement localiss au niveau privasculaire. Des cellules binucles et des
figures de mitose ont t observes. Un suivi clinique pendant plus d'un an a montr une rmission complte
des lsions aprs traitement glucocorticode (4 cas) ou exrse chirurgicale (2 cas). Le suivi n'a pas t possible
dans un cas.
Resumen Se estudiaron ocho casos de pododermatitis plasmactica felina, recogidos durante un periodo de
tres aos, aplicando tcnicas de histologa, (hematoxilina y eosina), histoqumica (metil verde-pironina) e
inmunohistoqumica (anticuerpos contra cadena ligera lambda de inmunoglobulinas). No se observ predileccin
por sexo, raza, edad, o por una garra en particular. La enfermedad empezaba como una tumefaccin de las almohadillas, seguida de ulceracin. Histolgicamente, las lesiones se caracterizaban por la presencia de un elevado
nmero de clulas plasmticas en un patrn predominantemente perivascular. Se observaron clulas plasmticas
binucleadas y figuras mitticas. El seguimiento clnico durante un ao revel una remisin total de las lesiones
tanto despus de la aplicacin de terapia glucocorticoidea (cuatro casos), como despus de la extirpacin quirrgica
(dos casos). No fue posible el seguimiento en un caso.
Zusammenfassung Acht Flle von ber einen Zeitraum von 3 Jahren gesammelter feliner Plasmazellpododermatitis wurden mit histologischen (Hmatoxylin-Eosin-Frbung), histochemischen (Methylgrn-PyroninFrbung) und immunhistochemischen (Antikrper gegen Lambda-L-Ketten von Immunglobulinen) Techniken
2003 European Society of Veterinary Dermatology, Veterinary Dermatology, 14, 333337
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untersucht. Es konnte keine Prdisposition hinsichtlich Geschlecht, Rasse, Alter oder Beteiligung der Pfoten
beobachtet werden. Die Erkrankung begann mit Schwellung der Fussballen gefolgt von Ulzerationen. Histologisch
waren die Lsionen durch das Vorhandensein einer grossen Anzahl von Plasmazellen mit einem vorrangig
perivaskulrem Verteilungsmuster charakterisiert. Zweikernige Plasmazellen und Mitosefiguren wurden beobachtet. Klinische Verfolgsuntersuchungen ber den Zeitraum von mehr als einem Jahr zeigten totale Remission
sowohl nach Glukokortikoidtherapie in vier Fllen als auch nach vollstndiger chirurgischer Exzision bei zwei
Tieren. In einem Fall waren Verfolgsuntersuchungen nicht mglich.