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Acral Lick Dermatitis in Dogs

Acral lick dermatitis is a firm, raised, ulcerative, or thickened plaque usually located on the back side of the wrist, on the ankle, or between the toes. This disease primarily affects dogs, and most commonly large breeds, especially Doberman Pinschers, Labrador Retrievers, Great Danes, Irish and English Setters, Golden Retrievers, Akitas, Dalmatians, Shar-peis, and Weimaraners. The age at which it occurs in animals varies with the cause. Some experts suggest that it is more common in males; others indicate there is no preference.

Symptoms and Types

The following are some symptoms that may be observed if your dog is suffering from acral lick dermatitis:

• Excessive licking and chewing of the affected area
• Occasionally, a history of trauma to the affected are
• Bald, ulcerative, thickened, and raised firm bumps (usually located on the back of the ankle, heel, or between the toes)
• Lesions often occur singly, although they may occur in more than one location

Causes 

• Skin diseases, such as staph infections
• Allergies
• Hormone problems, such as hyperthyroidism
• Mites
• Fungal infection
• Reaction to a foreign body
• Cancer
• Arthritis
• Trauma
• Nerve dysfunction

Diagnosis 

A veterinarian will first need to do a behavioral history on your dog. The following are a list of other possible examinations generally used to diagnose acral lick dermatitis:

• Skin scrapings, fungal and bacterial cultures, biopsies and Tzanck preparations (for herpes infection)
• Skin allergy testing – allergic animals often have multiple-lick inflammation and other areas of itching compatible with the specific allergy
• Laboratory tests to rule out endocrine diseases (such as hyperthyroidism), bacterial infections, cancer, fungus infections, and parasites
• Food-elimination diet

It is important that the veterinarian rule out any underlying diseases prior to diagnosing neurologically caused (psychogenic) skin disorders.

Treatment 

Acral lick disease is difficult to treat, especially if no underlying cause is identified. Your dog must get plenty of attention and exercise; counterconditioning may also be helpful. Physical restraints such as Elizabethan collars and bandaging can be used in the short term. Diet, however, should remain the same, unless an allergy is suspected. And surgery is only used if all other therapies have been exhausted.

The following medication types may be used to treat this medical condition:

1. Antibiotics

• Based on bacterial culture and sensitivity
• Give to your dog until infection is completely resolved, often at least six weeks

2. Systemic

• Antihistamines
• Psychotropic drugs may be helpful
• Selective serotonin reuptake
• Hormone treatment
• Antidepressants

3. Topical

• Topical medications should be applied with gloves
• Dog must be kept from licking the area for 10 to 15 minutes

Living and Management

If an underlying disease is found to be the cause, treating it should help prevent the dermatitis from recurring in your dog. If it is not found, neurological causes -- obsessive compulsive or self-mutilation disorders -- may be to blame. In these cases, prognosis is guarded.

It is important that you monitor your dog's licking or chewing.