Devadharshini Kamalakannan1 , Vanmathi Arulselvam1,* , Abiramy Prabavathy Arumugam2, Devadevi Narayanan2, and Vijayalakshmi Padmanadan2 1Rajiv Gandhi Institute of Veterinary Education and Research, Kurumbapet, Puducherry, India 2Department of Veterinary Medicine, Rajiv Gandhi Institute of Veterinary Education and Research, Kurumbapet, Puducherry, India * Corresponding author: Vanmathi Arulselvam, Rajiv Gandhi Institute of Veterinary Education and Research, Kurumbapet, Puducherry, India. Email: vaan1409@gmail.com
Abstract:
Introduction: Acral lick dermatitis is a skin injury commonly noticed in dogs with obsessive licking behavior. The lesions are usually noticed on the distal extremities which become raised, thickened, and plaque-like. Case report: A five-year-old male Labrador retriever dog was presented to the Small Animal Medicine Unit of Veterinary Clinical Complex (VCC), Rajiv Gandhi Institute of Veterinary Education and Research (RIVER), Puducherry, India, with a history of a superficial wound on the metatarsal region of the right hind limb with bleeding and continuous licking since a month. Clinical examination of the lesion showed a nodular eczematous lesion of 2 cm thickness, while other vital parameters were normal. Based on the licking behavior and other investigations, the skin lesions were diagnosed as acral lick dermatitis. Treatment included the application of Ointment Triamcinolone acetonide (topically) for a month. The licking was controlled using E-collar, and the dog was engaged in playful activities to overcome boredom. The lesion regressed completely within a month and hence was treated uneventfully. Conclusion: Diagnosis and identifying the root cause of the skin disorder can determine the course of treatment. Topical application of corticosteroids (triamcinolone acetonide) and methods, such as E-collar,to control the licking behavior, helped the animal’s recovery.
1.Introduction:
Acral lick dermatitis (ALD), also called lick granuloma, is a common, self-inflicted skin disorder with a focal lesion usually found occurring on the distal (acral) extremities of the limbs1. The common site for excessive compulsive licking is usually on the anterior carpal or metatarsal skin. Male dogs of larger breeds are commonly affected. Initially, the lesion appears small and gradually increases in size with expanded licking. Later, alopecia develops, and the lesions become firm, raised, thickened, and plaque leading to nodular ulceration, fibrosis, and hyperpigmentation2. Continuous licking also leads to secondary infections like deep pyoderma and furunculosis. The etiology is usually multifactorial3 with an underlying psychological factor. The possible reasons are loneliness, confinement for a long period, a female dog in heat nearby, a death in the family, and the moved apart of children or members of the family. Other causes include tumors, infection, trauma, and orthopedic problems2. Histopathological findings are supportive in confirming the diagnosis, including epidermal hyperplasia with marked rete ridge formation, and compact orthokeratosis hyperkeratosis, which strongly suggests chronic surface irritation and fibrosis of the dermal papillae4. Treatment includes behavior-modifying drugs, such as anxiolytics (alprazolam, diazepam, and lorazepam), tricyclic antidepressants (fluoxetine, amitriptyline, imipramine, and clomipramine), endorphin blocker (Naltrexone) and endorphin substitute (hydrocodone) medications, and acupuncture therapy5. This article described a case of Acral Lick Dermatitis (ALD) and its successful management. 2. Case report A five-year-old male Labrador retriever dog was referred to Small Animal Medicine Unit, Veterinary Clinical Complex, Rajiv Gandhi Institute of Veterinary Education and Research, Puducherry, India, with a history of a wound on the metatarsal region with bleeding which started as a crust-like lesion and then increased gradually on continuous licking. The lesion was painful on touch and hence reduced its exercise time. On clinical examination, the dog was active, popliteal lymph nodes were palpable, mucous membrane was pink, and the rectal temperature was 101.7°F (38.7°C). The lesion on the metatarsal region of the right hind limb was firm, raised, nodular, and erythematous (Figure 1). Other skin diseases caused by parasites (such as Demodex, Sarcoptes) and fungal organisms were ruled out by skin scraping examinations (deep skin scraping, direct microscopic examination). An impression smear was taken, and gram staining was done. There was no evidence of gram-negative and gram-positive bacterial organisms. The dog did not show any signs of orthopedic problems. Based on the history, clinical signs and other dermatological examinations, the skin lesion was diagnosed for acral lick dermatitis. The case was diagnosed as ALD without any secondary infections and was treated with topical glucocorticoid ointment of Triamcinolone acetonide 0.1 % (TRIAMADERMTM, Nulife Pharmaceuticals, India), and bandaging was done on the lesion to prevent further trauma. Besides, the owner had been advised to apply Elizabethan collar (E-collar) constantly and increase the play time and exercise with the dog to overcome the obsessive-compulsive disorder. After 15 days of application of the ointment and wearing E -collar, the erythema and swelling reduced (Figure 2). After 6 weeks, the animals showed complete healing, and hair growth was also noticed (Figure 3).
