Multimodal therapy of feline dermatophytic pseudomycetoma in a cat

Abstract This case report describes an unusual presentation of dermatophytic pseudomycetoma (DPM) caused by Microsporum canis in a Persian cat, characterised by alopecia, thickened nasal plaques and firm subcutaneous nodules with draining sinuses—features rarely reported. DPM is a deep dermal and subcutaneous fungal infection, predominantly affecting Persian cats due to suspected genetic predisposition. Diagnosis was based on clinical signs, Wood's lamp examination, cytology, fungal culture and histopathology revealing the Splendore‒Hoeppli reaction. Under general anaesthesia, two nodules were excised for culture and histological evaluation. Treatment included systemic fluconazole, topical ketoconazole and intralesional amphotericin B, with adjunctive oral vitamin A + D and zinc sulphate. Marked clinical improvement was observed, and no recurrence occurred over 14 months. Monotherapy is often ineffective, but this multimodal approach achieved sustained resolution. This report highlights the diagnostic challenges of DPM and presents a successful alternative treatment strategy for this rare and refractory condition in feline dermatology.