Acral Lick Dermatitis PDF - Blackwell's Five-Minute Veterinary Consult

16 Blackwell’s Five-Minute Veterinary Consult A Acral Lick Dermatitis Bacterial culture and sensitivity—tissue Combine/withdraw administration of these...

16 Blackwell’s Five-Minute Veterinary Consult A Acral Lick Dermatitis Bacterial culture and sensitivity—tissue Combine/withdraw administration of these cultures may differ from surface culture. medications carefully. Food elimination diet—determine food ­ BASICS Topical allergy. Pruritus—flunixin meglumine and fluo- OVERVIEW Intradermal allergy testing—atopy. cinolone in dimethyl sulfoxide (combined), Compulsion to lick limb/s resulting in Biopsy—to rule out neoplasia, other topical capsaicin products; intralesional plaque formation. infections. corticosteroids rarely helpful; wear gloves Skin/exocrine affected. Behavioral history (additional behavioral when applying; prevent licking of area for signs typical). 10–15 minutes. SIGNALMENT Neurologic and orthopedic evaluation. Dogs. CONTRAINDICATIONS/POSSIBLE Most common in large breeds—Labrador PATHOLOGIC FINDINGS Histopathology—epidermal hyperplasia, INTERACTIONS retrievers, Doberman pinschers, Great Danes, Doxepin—caution using with monoamine Irish setters, golden retrievers, German plasmacytic dermal inflammation, folliculitis, furunculosis, perihidradenitis, hidradenitis, oxidase inhibitors, clonidine, anticonvulsants, shepherd dogs, boxers, and Weimaraners. epitrichial gland dilation/rupture, vertical oral anticoagulants, steroid hormones, anti­- Median age 4 yrs, range 1–12 yrs; no sex streaking fibrosis. histamines, or aspirin. predilection. Antihistamines—may cause sedation. SIGNS Psychotropic medications should be Excessive licking of affected area. combined and/or withdrawn carefully. Alopecic, eroded/ulcerated, thickened, and Cardiotoxicity and hepatoxicity—rare cases raised firm plaques with scabs and exudation, ­ TREATMENT in animals on TCAs. Routine monitoring usually located on dorsal aspect of carpus, Rule in/out bacterial, fungal, ectoparasitic, recommended. metacarpus, tarsus, or metatarsus. endocrine causes and treat accordingly along Single or multiple lesions. with pruritus control. If infection resolves and pruritus and/or CAUSES & RISK FACTORS lesions persist, consider biopsy, allergy Anything causing local irritation or lesion workup, neurologic/orthopedic exam, ­ FOLLOW-UP may initiate lick–itch cycle. Monitor level of licking and chewing closely. Associated diseases: staphylococcal radiographs, behavioral modification. Treat underlying disease to prevent Physical restraints—to permit healing. furunculosis, hypersensitivity, endocrinopathy, recurrence. Limited research to support effectiveness: demodicosis, dermatophytosis, foreign body If no underlying disease detected, psycho- reaction, neoplasia, underlying joint disease radiation, acupuncture, CO2 laser, cryosurgery, standard surgery. genic causes possible (compulsive or self- or arthritis, trauma, neuropathy, psychogenic, mutilation disorder); prognosis is guarded. Difficult to treat, especially if no underlying or sensory nerve dysfunction. cause found; warn owner that patience and time are necessary. ­ MISCELLANEOUS ­ DIAGNOSIS AGE-RELATED FACTORS DIFFERENTIAL DIAGNOSIS ­ MEDICATIONS Dogs