Canine Acral Lick Dermatitis
Karin Beale, DVM, DACVD, Gulf Coast Veterinary Specialists
Acral lick dermatitis (lick granuloma) is a lesion induced by chronic licking, most often on a dorsal forelimb between the metacarpals and elbow, although other locations have been noted.
Acral lick dermatitis, which is more common in large-breed dogs, is initiated by pruritus, pain, or behavioral factors, although pruritus may be the most common initiating factor. Careful history and examination are essential to evaluate any potential underlying allergic disease. Signs may include recurrent skin and ear infections, recurrent hot spots, or pruritus associated with other areas (eg, feet, face, trunk). However, pruritus can also result from infection (eg, bacterial, fungal).
The disorder, which is typically diagnosed according to clinical appearance and a patient history of licking the lesion, is characterized by hair loss and an ulcer surrounded by thick plaques. Pain associated with trauma, osteoarthritis, fractures, surgical sites, or peripheral neuropathies may also initiate excessive licking.
Because other conditions may appear clinically similar (eg, deep fungal infection, neoplasia),1 skin biopsy with histopathology is indicated. Diagnostics (eg, digital imaging) may be indicated when there are no signs of pruritus or allergic disease elsewhere.
Although patients may have acral lick dermatitis attributable to a behavioral abnormality, this usually is not the sole cause for the disorder, particularly if the patient has no other behavioral manifestations. However, eventually the licking behavior can become a primary factor.
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