Abstract

Background:
Head-and-neck pruritus (HNP) is one of the four reaction patterns associated with feline atopic skinsyndrome (FASS). In some cases, the response to glucocorticoid treatment is insufficient, and the optimal therapeutic strategies for refractory HNP remain unclear.

Case Description:
A 6-year-old spayed female domestic shorthair cat presented with severe pruritus and a characteristic cross-shaped ulcer on its dorsal cervical region. Based on the clinical presentation and routine dermatological examination, infectious and parasitic diseases were considered unlikely. Prednisolone was initiated at 2.73 mg/kg once daily for suspected HNP-type FASS. Despite treatment, the ulcer gradually enlarged. On day 36, a multilayer protective bandage was applied to prevent self-trauma and maintain a moist wound environment. The ulcer then began to contract and completely resolved approximately 35 days after bandaging. No recurrence was observed after bandage removal, and hair regrowth was noted at the ulcer site.

Conclusion:
These clinical findings suggest that protective bandaging contributed to lesion improvement. One possible explanation is that wound-induced pruritus may have sustained self-trauma, and physical protection may have interrupted this cycle and thereby facilitated healing. Furthermore, although FASS is fundamentally caused by hypersensitivity, the current exclusion-based diagnostic framework may encompass a variety of distinct conditions, including feline idiopathic ulcerative dermatitis and nonhypersensitivity conditions such as behavioral or neurological factors, which may partly explain why glucocorticoid treatment is insufficient in some cases. Although conclusions cannot be generalized from a single case, protective bandaging may be considered a potential adjunctive option in selected refractory HNP cases after other diseases have been reasonably ruled out.

Key words: Feline atopic skin syndrome; Head-and-neck pruritus; Protective bandage; Ulcerative dermatitis.