Skin: acral lick granuloma

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Sections available in full article Introduction, Presenting signs, Age predisposition, Breed predisposition, Cost considerations, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr David Scarff BVetMed CertSAD MRCVS
Dr Rosanna Marsella DVM DipACVD
Dr Stephen White DVM DipACVD
Synonyms Acral lick dermatitis

Introduction

  • Cause : multifactorial.
  • Signs : persistent licking and chewing of local area of skin producing well-circumscribed, alopecic plaques, often ulcerated.
  • Dorsal aspect of distal limb (more commonly thoracic limb, often the left thoracic limb).
  • Diagnosis : clinical signs, histopathology, radiography.
  • Treatment : antibiotics, behavior-modifying medications, topical anti-inflammatory medications.
  • Prognosis : dependent on underlying causes; may be controllable but not curable.
    Print off the owner factsheet Acral lick granuloma Acral lick granuloma to give to your client.

Diagnosis

Clinical signs

  • Lesion appearance almost pathognomonic Lick granuloma: hair discoloration.

Diagnosis

Differential diagnosis

  • Neoplasia.
  • Causes of persistent cutaneous erosion/ulcer, eg poor healing due to hyperadrenocorticism Hyperadrenocorticism.
  • Dermatophytosis Skin: dermatophytosis.
  • Foreign body.

Sequelae

Prognosis

  • Guarded: tends to recur.

Reasons for treatment failure

  • Tendency to recur even if primary cause detected.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Shumaker A K, Angus J C, Coyner K S, Loeffler D G, Rankin S C, Lewis T P (2008) Microbiological and histopathological features of canine acral lick dermatitis. Vet Dermatol in press PubMed.
  • Denerolle P, White S D, Taylor T S, Vandenabeele S I (2007) Organic diseases mimicking acral lick dermatitis in six dogs. JAAHA 43 (4), 215-220 PubMed.
  • Hewson C J et al(1998) Efficacy of clomipramine in the treatment of canine compulsive disorder. JAVMA 213 (12), 1760-1766 PubMed.
  • Wynchank D et al(1998) Fluoxetine treatment of acral lick dermatitis in dogs - a placebo-controlled randomized double blind trial. Depress Anxiety 8 (1), 21-23.
  • Rivers B, Walters P A & McKeever P J (1993) Treatment of canine acral lick dermatitis with radiation therapy - 17 cases (1979-1991). JAAHA 29 , 541-544.
  • Goldberger B A, Rapaport J L (1991) Canine acral lick dermatitis: response to antiobsessional drug clomipramine. JAAHA 27 , 179-182.
  • White S D (1990) Naltrexone for treatment of acral lick dermatitis in dogs. JAVMA 196 , 1073-1076 PubMed.
  • Owen L N (1989) Canine lick granuloma treated with radiotherapy. JSAP 30 , 454-456.

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