Changes

==Diagnosis==

==Diagnosis==

A detailed history is important in order to aid in determining the underlying cause of the condition. A detailed description of the environment (bedding, quality of turnout, exposure to wet conditions) is particularly important. In order to rule out zoonotic infections such as Dermatophytosis or Cheyletiella, the owner should be questioned regarding other in-contact animals or humans have been affected.

A detailed history is important in order to aid in determining the underlying cause of the condition. A detailed description of the environment (bedding, quality of turnout, exposure to wet conditions) is particularly important. In order to rule out zoonotic infections such as Dermatophytosis or Cheyletiella, the owner should be questioned to determine if other in-contact animals or humans have been affected.

The seasonal nature of the condition combined with a history of continual wetting may aid in diagnosis. However, the list of differential diagnoses for this condition is lengthy and several important conditions should be ruled out. If lesions are restricted to non-pigmented skin only, liver enzymes and bile acids should be evaluated in order to rule out photosensitisation as a cause of disease. Skin scrapes should be performed in order to rule out parasites such as Chorioptes mites (especially in heavily-feathered horses). Bacterial swabs for culture and skin biopsy may be useful in refractory cases.  

The seasonal nature of the condition combined with a history of continual wetting may aid in diagnosis. However, the list of differential diagnoses for this condition is lengthy and several important conditions should be ruled out. If lesions are restricted to non-pigmented skin only, liver enzymes and bile acids should be evaluated in order to rule out photosensitisation as a cause of disease. Skin scrapes should be performed in order to rule out parasites such as Chorioptes mites (especially in heavily-feathered horses). Bacterial swabs for culture and skin biopsy may be useful in refractory cases.  

==Treatment==

==Treatment==

Treatment is dependent on the underlying cause but includes removal of environmental triggers and alterations in husbandry. The horse should be removed from wet, muddy conditions and stabled on clean, dry bedding. The affected area should be gently clipped and cleansed with a mild antiseptic solution (e.g. Hibiscrub). Horses that are severely painful may require sedation for this to be performed. The necrotic and exudative skin should be gently debrided away and the area should then be dried thoroughly. Once debridement is complete, topical antibiotic creams may be applied in order to aid healing.  

Treatment is dependent on the underlying cause but includes removal of environmental triggers and alterations in husbandry. The horse should be removed from wet, muddy conditions and stabled on clean, dry bedding. The affected area should be gently clipped and cleansed with a mild antiseptic solution (e.g. Hibiscrub). Horses that are severely painful may require sedation for this to be performed. The necrotic and exudative skin should be gently debrided away and the area should then be dried thoroughly. Once debridement is complete, topical antibiotic creams may be applied in order to aid healing. Stabling during wet weather should be recommended as well as avoiding turnout before the morning due has dried.  

In chronic cases, treatment may be difficult or impossible and may require surgical excision of affected tissue.

In chronic cases, treatment may be difficult or impossible and may require surgical excision of affected tissue.