Skin: idiopathic/granulomatous sebaceous adenitis

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Introduction

  • Causes : an inflammation of and around the sebaceous glands leading to loss of these structures.
  • Signs : dry skin, scaling and hair loss.
  • Certain breeds are predisposed, but has been seen in over 60 breeds plus crossbreeds.
  • Etiology and pathogenesis unclear.
  • Treatment : shampoos, sprays, immunomodulatory therapy and antibacterials.
  • Prognosis : guarded but variable.

Diagnosis

Clinical signs


Long coated breeds
  • Symmetrical and partial multifocal alopecia with excess scale and dull brittle hairs . (Figs. 1-2)
  • Lesions first observed along dorsal midline.
  • May affect specific areas - dorsal nasal planum, top of head, dorsal neck, trunk and tail.
  • Initially non pruritic, may not progress beyond this stage.
  • Progression results in the formation of tightly adherent silver-white scale, follicular casts around hair shafts, and small tufts of matted hair.
  • Predisposed to secondary bacterial folliculitis at this stage.
Short coated breeds
  • Sebaceous adenitis 01Fig.3 Sebaceous adenitis 01
    Lesions begin as annular, or arciform, areas of scaling and alopecia predominantly on trunk (Fig. 3).
  • Affected areas enlarge peripherally, to become polycyclic, and occasionally coalesce.
  • Fine, white non-adherent scale.
  • Secondary pyoderma uncommon.

Differential diagnosis

  • Keratinization defects .
  • Endocrine skin disease (later stage of disease).

Outcomes

Prognosis

  • Response to therapy varies somewhat, depending on the severity or chronicity of the disease and on the breed of animal.
  • Prognosis is poorest when sebaceous glands have been completely destroyed.
  • Evidence suggests that treatment with cyclosporin A, alone or in combination with topical therapy, reduces macrophagic and lymphocytic inflammation and may achieve some regeneration of sebaceous glands.
  • Some dogs have cyclic patterns of spontaneous improvement and worsening.
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