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Lick Granuloma (Acral lick dermatitis or ALD)

By: Dr. Rosanna Marsalla

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  • In any case of lick granuloma, diagnosis should include deep skin scraping to rule out demodicosis and fungal culture to rule out dermatophytosis.

  • It is important to note that deep skin scrapings may be falsely negative in areas that are excessively fibrotic and biopsies may be necessary to rule out demodicosis.

  • Biopsy for histopathology and culture should also be taken to rule out fungal infections, pythiosis, neoplasia (cancer) and to identify the bacteria responsible for the infection (Pseudomonas is often present together with Staphylococcus).

  • Pythiosis is a potentially lethal subcutaneous fungal disease common in Southeastern United States. It is caused by an alga present in standing water and dogs become infected swimming in infected areas. It has a predilection for German shepherds and Labrador retrievers and is intensely pruritic and rapidly progressive. If the animal has a history of living in endemic areas for pythiosis, a biopsy for histopathology and culture should be taken as soon as signs compatible with a lick granuloma are observed. Failure to make an early diagnosis may result in the animal's death due to the fact that the only possible treatment at the present time is aggressive surgery.

  • Biopsy of true cases of lick granuloma reveals marked epidermal hyperplasia and dermal fibrosis. It is common to see folliculitis, or inflammation of the hair follicle, and furunculosis, which is a ruptured hair follicle, with secondary bacterial infection.


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