Lick Granuloma (Acral Pruritic Dermatitis)

Condition Overview

A lick granuloma is an open sore, usually at the ankle or wrist, perpetuated by constant licking. It is seen most often in large, short-haired dogs such as Doberman Pinschers, Great Danes, Labrador Retrievers, and bird dogs.

Symptoms

As the dog licks at her wrist or ankle, the hair is rubbed off and the surface of the skin becomes red and shiny. Eventually, the skin becomes raised, thick, hard, and insensitive to pressure. During this time however, it remains fresh looking from the constant licking.

All symptoms +

Causes

At one time, lick sores were thought to be psychogenic in origin and related to boredom and inactivity. It now appears that many cases are preceded by an itchy skin disease (such as canine atopy) that starts the lick cycle. Other possible initiating causes include demodectic mange, a bacterial or fungal infection, prior trauma, and underlying joint disease.

The precipitating event focuses on the dog's attention to the area. The licking then becomes a habit that may be perpetuated by psychological events, so behavior may still be a factor.

Diagnosis

These areas are visible on the dogs skin. Look for skin that is red, raised, thick, hard, and insensitive to pressure.

Treatment

It is important to review the course of events in an attempt to identify the precipitating cause. If a disease such as canine atopy is diagnosed, the medical treatment is directed toward that condition.

1. Trim the remaining hair around the sore.

2. Soak and clean the area thoroughly. An antiseptic liquid soap like Betadine Skin Cleanser works great, but soap and water will suffice if you do not have access to this solution.

3. An over the counter cortisone cream like Cortaid will calm itching and inflammation. You can use it 2 - 3 times a day for temporary relief until you see the vet.

Local treatment may involve the use of topical and injectable steroids, radiation therapy, bandaging, surgical removal, cryotherapy, and acupuncture.

If the sore has become infected you'll probably need to give your dog oral antibiotics for at least 7 days, and possibly up to 2 weeks.

Since lick sores are perpetuated by psychogenic factors, a change in the dog's routine or lifestyle should be part of the treatment program. For example, some arrangement may need to be made to provide company for the dog while the owner is away. An Elizabethan collar can keep the dog from reaching the irritated areas. Covering the spot with a bitter apple spray may be useful, as long as the spray will not interfere with the healing process. Behavior modifying drugs such as Prozac or Valium may be beneficial in breaking the cycle in some cases.

Prevention

If the cause of the injury is psychogenic, constant behavior modification can help dogs break the habit of incessant licking. Re-train your dog to respond to a command such as "stop" or "stop chewing" every time they being licking or chewing a limb.

Support

Please contact your veterinarian for assistance with this disease.