Equis ISSN 2398-2977

Skin: verrucose pastern dermatitis

Synonym(s): Greasy heel

Contributor(s): Prof Derek Knottenbelt, David Senter

Introduction

  • A chronic hyperplastic inflammatory dermatopathy, although probably not a specific disease entity, which is the end stage of many inflammatory diseases that have similar clinical features.
  • Recognized historically in military horses in particular for hundreds of years; a major cause of debility and loss in the Crimean war; many old text books dating back to the early 18th century describe the condition eloquently.
  • Although the disease remains rare, more cases are being reported recently, and neglected cases are a common cause of cruelty investigations and prosecution.
  • Cause: thought to include an immunological component, possibly with some genetic predisposition and  altered or impaired skin immunity. 
  • Signs: scaling, crusting, erosion, exudation and proliferative dermatitis of the pastern and heels and sometimes extending to the cannon, leg filling is also common. 
  • Diagnosis: history and clinical signs.
  • Treatment: treat underlying cause and reduce exacerbating secondary factors; antiseptic washes, antibacterial dressings, surgical removal of abnormal exophytic and open granulomatous tissue, NSAIDs, antibiotics.
  • Prognosis: poor once the condition is established.

Pathogenesis

Etiology

  • Identification of original cause is usually impossible but history of chorioptic mange and mud fever/dermatophilosis is usually reported.
  • Condition is usually seen in an advanced state and complicated by secondary infection and trauma with chronic long-standing inflammation.

Predisposing factors

General
  • White skinned, feathered limbs.
  • Heavy horses with a high pastern circumference and tufted fetlocks.

Timecourse

  • Chronic changes reflect long course of disease (often over many years).

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Boerma S, Back W & Sloet van Oldruitenborgh-Oosterbaan M M (2012) The Friesian horse breed: A clinical challenge to the equine veterinarian? Equine Vet Educ 24 (2), 66-71 VetMedResource.
  • Geburek F, Deegan E, Hewicker-Trautwein M & Ohnesorge B (2005) The development of verrucose pastern dermatitis syndrome in heavy draught horses. Part 1: Review of the literature. Deutsch Tierarztliche Wocheschrift 112, 211-214 PubMed.
  • Geburek F, Deegan E, Hewicker-Trautwein M & Ohnesorge B (2005) Verrucose pastern dermatitis syndrome in heavy draught horses. Part 2: Clinical findings. Deutsch Tierarztliche Wocheschrift 112, 211-214 PubMed.
  • Ferraro G L (2001) Pastern dermatitis in Shires and Clydesdales. J Equine Vet Sci 21, 524-526 VetMedResource.
  • English M & Pollen S (1995) Pastern dermatitis and unguilysis in two draft horses. Equine Pract 17, 24-26 VetMedResource.

Other sources of information

  • Miles W J (1897) Practical Farriery. William Mackenzie, UK. pp 354-355.


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