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Lick Granuloma (Acral lick dermatitis or ALD)

By: Dr. Rosanna Marsalla

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This condition is also called Acral Lick Dermatitis (ALD). Large breed dogs are predisposed including Doberman Pinschers, Great Danes, golden retrievers, Irish setters, Labrador retrievers, German short-haired pointers,Weimmaraners, shar peis, boxers and German shepherds. It seems to be more common in males (2:1 ratio), and it can start at any age, but most dogs are middle age or older (most > 5 years of age).

Carpal (wrist) or metacarpal areas are the most common sites. Possible underlying causes for lick granulomas are hypersensitivities to inhalants, food and fleas, demodicosis, hypothyroidism, dermatophytosis, pre-existing wounds or trauma, joint disease, staphylococcal pyoderma never properly addressed, psychogenic and neurogenic.

Boredom may be a significant factor to trigger the habit of licking, especially in large, active dogs. Lick granulomas are almost always secondarily infected at the time of presentation and the infection contributes to the pruritus thus a vicious cycle is created.

It has been reported that up to 70% of dogs with ALD have concurrent anxiety or fear based behavioral problems. These include separation anxiety and noise phobias)


Excessive licking may trigger the release of endorphins, which may have an analgesic effect thus raising the threshold of pain.

Clinical Presentation

  • Raised, ulcerated firm masses are seen, most often on the cranial carpus.

  • Chronic lesions become hard and thick. Peripheral hyperpigmentation is common. Arthritis may be associated with long- standing lesions.

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