Skin Lesions in Feline Leishmaniosis: A Systematic Review

Abstract

Feline leishmaniosis (FeL) is increasingly reported throughout the world and skin lesions predominate in the clinical picture. There are, however, few evidence-based data on cutaneous feline leishmaniosis and directions are strongly needed for a better management of the disease. In this study, we systematically reviewed what is currently known about the clinical dermatological presentation of FeL through analysis of the literature and, further, by adding unpublished cases managed by Italian veterinary dermatologists. Sixty-six feline cases of cutaneous leishmaniosis published in 33 articles between 1990 and 2020 met the inclusion criteria and were analyzed. Six unpublished cases of cutaneous FeL managed by Italian dermatologists were also reviewed. The majority of cases were reported from South America, followed by Europe and North America. Nodules were the most frequently reported clinical signs and the presence of Leishmania in lesioned skin was assessed mainly by cytology. A total of six Leishmania species have been identified as being responsible for skin lesions. Coinfections by FIV or FeLV were reported in 12.1% and 9.1% of the cases, respectively. Clinical data including treatment have been analyzed and discussed to provide directives for proper management of the disease for which cats may also serve as domestic reservoirs for human infections.

Epidemiological and diagnostic aspects of feline leishmaniasis with emphasis on Brazil: a narrative review

“…Cytology is the most commonly used diagnostic method for skin lesions, but when amastigotes are not visualized by this technique, histological, immunohistochemical, or PCR-based diagnostics of the lesion samples are usually used (Abramo et al 2021). Lesion fragments are cultured in Novy-MacNeal-Nicolle (NNN) medium in search of promastigotes (Schubach et al 2004;Souza et al 2005;Simões-Mattos et al 2005).…”

Feline Leishmaniosis: An Emerging Public Health Problem

“…In fact, a recent systematic review summarizes the skin lesions in feline leishmaniosis, indicating that the most reported clinical signs were nodules, followed by ulcers, which were less frequently reported [74]. The most frequent clinical and clinicopathological abnormalities reported in feline leishmaniosis were skin and/or muco-cutaneous nodules and ulcers, and lymphadenomegaly [74]. Actually, clinical signs in cats could be due to co-infection with immunosuppressive disease such as cancer or viruses infection [38,42].…”

“…Administration of allopurinol seems to improve clinical signs, but it is not yet known if it may cause relapses as it does in dogs [22,93,94]. The LeishVet Guidelines (2018) recommended treatment of allopurinol 10 mg/kg 12 h, or 20 mg/kg 24 h, for at least 6 months [74]. Other treatments combine allopurinol with meglumine antimoniate, but some authors indicate that only the latter presents a good clinical response in cats [38,42].…”

“…While in dogs leishmaniosis is a chronic and progressive disease which affects all tissues and organs, in cats this pathology affects commonly spleen, liver, lymph nodes, bone marrow, kidney, and eyes, dermatological and mucocutaneous being the most frequent clinical forms ( Figure 1 ) and more frequent than dogs [ 23 , 70 , 71 , 72 , 73 ]. In fact, a recent systematic review summarizes the skin lesions in feline leishmaniosis, indicating that the most reported clinical signs were nodules, followed by ulcers, which were less frequently reported [ 74 ]. The most frequent clinical and clinicopathological abnormalities reported in feline leishmaniosis were skin and/or muco-cutaneous nodules and ulcers, and lymphadenomegaly [ 74 ].…”

“…Enzyme-linked immunosorbent assay (ELISA) is also used for diagnosis of FL, showing discrepant results compared with other techniques, which suggest that it should be combined with other parasitological and/or molecular techniques [ 81 ]. The immunological diagnostic methods recommended by LeishVet Guideline (2018) were IFAT with cut-off of 1:80, ELISA, DAT, with cut-off of 1/800, Western blot where a 18 kDa band should be detected [ 74 ]. As for dogs, interferon gamma (IFN-γ) analysis in cat’s blood could provide a better estimation of cat exposure to the disease when it is associated to serological and molecular tests [ 48 , 82 ].…”