Acral Lick Dermatitis

PetMD Editorial
Written by:
PetMD Editorial
Published: January 6, 2009
Acral Lick Dermatitis

Skin Diseases in Cats that Involve Licking


Acral lick dermatitis is a firm, raised, ulcerative, or thickened plaque usually located on the back side of the ankle, or between the toes. The age at which it occurs in cats varies with the cause. Some veterinarians believe it may more commonly affect males, while others indicate there is no predisposition.


Symptoms and Types


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


  • Excessive licking and chewing on the affected area
  • Occasionally, a history of trauma to the affected area
  • 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




  • 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




A veterinarian will first need to do a behavioral history on your cat. 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 cats 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.




Acral lick disease is difficult to treat, especially if no underlying cause is identified. Physical restraints such as Elizabethan collars and bandaging can be used in the short term to prevent your cat from licking or biting the irritated area. Your cat will need to get plenty of attention and exercise to rule out any problems related to anxiety or boredom. If your veterinarian makes a diagnosis based on behavioral problems, counter-conditioning may also help. Otherwise, and any major household changes should be avoided if possible, or at least a safe space should be provided for your cat so that environmental stressors are not an issue. Unless an allergy is suspected, diet should remain the same. Surgery is only recommended 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
  • Given to your pet until infection is completely resolved, often at least six weeks


2. Systemic


  • Antihistamines
  • Psychotropic drugs
  • Selective serotonin reuptake
  • Hormone treatment
  • Antidepressants


3. Topical

  • Topical medications should be applied with gloves to avoid contamination
  • Cat must be kept from licking the treated 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 cat. 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 cat's licking and chewing behavior.

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