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Also known as: '''''Juvenile sterile granulomatous dermatitis and lymphadenitis — juvenile cellulitis — puppy strangles — lymphadenitis apostematosa'''''

Also known as: '''''Juvenile Sterile Granulomatous Dermatitis and Lymphadenitis — Juvenile Cellulitis — Puppy Strangles — Lymphadenitis Apostematosa'''''

==Introduction==

==Introduction==

An underlying '''immune dysfunction''' is likely and bacterial involvement, when present, is secondary.

An underlying '''immune dysfunction''' is likely and bacterial involvement, when present, is secondary.

Sex predilections have not been noted, and rarely, adult dogs with identical clinical and histopathologic disease have been seen.

Sex predilections have not been noted, and rarely, adult dogs with identical clinical and histopathological disease have been seen.

==Clinical signs==

==Clinical Signs==

The initial clinical feature noted by the owners is '''acute swelling of the face''', especially of the eyelids, lips and muzzle.

The initial clinical feature noted by the owners is '''acute swelling of the face''', especially of the eyelids, lips and muzzle. It is markedly '''bilaterally symmetrical'''.

It is markedly '''bilaterally symmetrical'''.

'''Submandibular lymphadenopathy''' is usually also present.

'''Submandibular lymphadenopathy''' is usually also present.

Within 24 hours, '''bilaterally symmetrical erythema, papules, nodules, pustules and vesicles''' appear.

Within 24 hours, '''bilaterally symmetrical erythema, papules, nodules, pustules and vesicles''' appear. Crusting occurs and copious purulent material may drain from the lesions.

A '''highly purulent [[Otitis Externa - Cat and Dog|otitis externa]]''' may also develop. '''Secondary bacterial infection''' of the lesions is common. Systemic signs often occur, such as '''lethargy, fever and anorexia'''.

 

A '''highly purulent otitis externa''' may also develop.

 

'''Secondary bacterial infection''' of the lesions is common.

 

Systemic signs often occur, such as '''lethargy, fever and anorexia'''.

==Diagnosis==

==Diagnosis==

Definitive diagnosis involves '''skin or lymph node biopsies''' which show a pyogranulomatous perifolliculitis and lymphadenitis with no causative agent identified.

Definitive diagnosis involves '''skin or lymph node biopsies''' which show a pyogranulomatous perifolliculitis and lymphadenitis with no causative agent identified.

Multiple skin scrapings to rule out generalised demodecosis and smears from pustules to rule out a primary bacterial infection should be performed. A drug eruption should also be considered and a detailed history should be taken.

Multiple skin scrapings to rule out generalised [[demodecosis]] and smears from pustules to rule out a primary bacterial infection should be performed. A drug eruption should also be considered and a detailed history should be taken.

Some affected puppies show a leucocytosis with neutrophilia and a non-regenerative anaemia.

Some affected puppies show a leucocytosis with neutrophilia and a [[:Category:Anaemia|non-regenerative anaemia]].

==Treatment==

==Treatment==

The disease may be fatal if left untreated, but the outcome is usually favourable in most treated cases.

The disease may be fatal if left untreated, but the outcome is usually favourable in most treated cases.

'''Systemic corticosteroids''' are necessary to lead to a resolution of signs, and '''systemic antimicrobials''' can also be used to treat secondary infections.

'''Systemic [[corticosteroids]]''' are necessary to lead to a resolution of signs, and '''systemic [[antimicrobials]]''' can also be used to treat secondary infections.

'''Topical therapy''' to remove the purulent exudate might also be helpful.

'''Topical therapy''' to remove the purulent exudate might also be helpful.

Gross, T. L. (2005) '''Skin diseases of the dogs and cat: clinical and histopathologic diagnosis''' ''Wiley-Blackwell''

Gross, T. L. (2005) '''Skin diseases of the dogs and cat: clinical and histopathologic diagnosis''' ''Wiley-Blackwell''

[[Category:Integumentary System - Pathology]]

[[Category:Integumentary System - Pathology]]