Hepatocutaneous syndrome

Superficial necrolytic dermatitis • necrolytic migratory erythema • glucagonoma syndrome • diabetic dermatopathy • ulcerative dermatosis

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  • Very rare condition in dogs.
  • Cause : in humans is a paraneoplastic dermatosis usually associated with glucagonomas, in dogs associated with several hepatopathies, diabetes, Cushing's syndrome.
  • Signs : dermatological signs at typical sites (feet, muzzle, axilla, inguinal, anogenital area); signs of underlying hepatic pathology, diabetes mellitus.
  • Diagnosis : signs, laboratory tests of hepatic function, skin histopathology.
  • Treatment : management of underlying disease, symptomatic care.
  • Prognosis : poor.


Clinical signs

  • CrustFig.1 Crust
    Typical skin lesions with crusting (Fig. 1) and exudation around muzzle, feet, perineal (axilla and groin) regions.
  • Fissured footpads.
  • Secondary infection common and may be fungal.
  • Abnormal hepatic size (hepatomegaly if diabetes mellitus, often small in cirrhosis).
  • Jaundice.
  • Pallor (often associated with anemia).
  • Skin lesions may precede signs of liver disease by some time (months).

Differential diagnosis



  • Poor: survival times are poor (median 5 months from development of lesions) and underlying pathology is usually severe.
  • Diabetes mellitus may not be controllable.
  • Disease is incurable.

Expected response to treatment

  • Reduction in pain/pruritus from skin lesions.
  • Reduction in hepatic enzymes (if raised) and [bile acids].
  • Reduction in [blood glucose].

Reasons for treatment failure

  • Response is usually poor.
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