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Also known as: '''''Acral Lick Granuloma — Acral pruritic nodule — Lick granuloma'''''
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Also known as: '''''Acral Lick Granuloma — Acral Pruritic Nodule — Lick Granuloma'''''
    
==Introduction==
 
==Introduction==
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It might be that a predisposing cause or initial insult induces attention and licking, and exposes sensory nerves in the lower epidermis, resulting in a continuous stimulus to lick.
 
It might be that a predisposing cause or initial insult induces attention and licking, and exposes sensory nerves in the lower epidermis, resulting in a continuous stimulus to lick.
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'''Stress and medical triggers''' can both contribute to the development of acral lick dermatitis in an individual dog. These may include: hypersensitivities, ectoparasites and other pruritis conditions, fractures, implants, osteomyelitis, arthritis, intervertebral disk disease, neurological lesions.
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'''Stress and medical triggers''' can both contribute to the development of acral lick dermatitis in an individual dog. These may include: [[:Category:Hypersensitivity|hypersensitivities]], ectoparasites and other pruritic conditions, fractures, implants, [[osteomyelitis]], [[arthritis]], intervertebral disk disease, neurological lesions.
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The stereotypical behavious is often inadvertently '''reinforced by the attentive owner'''.  
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The stereotypical behaviour is often inadvertently '''reinforced by the attentive owner'''.  
    
'''Large breeds''' such as Doberman Pinschers, Great Danes, Golden Retrievers and Irish Setters are more commonly affected, and males are twice as often affected than females.
 
'''Large breeds''' such as Doberman Pinschers, Great Danes, Golden Retrievers and Irish Setters are more commonly affected, and males are twice as often affected than females.
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Damage is done to the skin and it is inevitably '''secondarily infected''', usually with staphylococci but sometimes with gram-negative bacteria and anaerobes. '''Chronic folliculitis and furunculosis''' are important and result in further inflammation, fibrosis and self-trauma.
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Damage is done to the skin and it is inevitably '''secondarily infected''', usually with [[Staphylococci]] but sometimes with gram-negative bacteria and anaerobes. '''Chronic folliculitis and furunculosis''' are important and result in further inflammation, fibrosis and self-trauma.
    
==Clinical Signs==
 
==Clinical Signs==
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'''Radiography''' of the affected limb can be performed, and there are often periosteal reactions in the underlying bone.
 
'''Radiography''' of the affected limb can be performed, and there are often periosteal reactions in the underlying bone.
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'''Biopsies''' should always be taken, and histopathology performed to rule out other differentials. '''Culture and sensitivity''' should be performed to identify suitable antimicrobials.
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'''Biopsies''' should always be taken, and histopathology performed to rule out other differentials.  
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'''Culture and sensitivity''' should be performed to identify suitable antimicrobials.
    
Electrophysiological studies have suggested that there is a mild distal sensory polyneuropathy, which may cause or be a result of the disease.
 
Electrophysiological studies have suggested that there is a mild distal sensory polyneuropathy, which may cause or be a result of the disease.
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Harvey, R. (2009) '''A colour handbook of skin diseases of the dog and cat''' ''Manson Publishing''
 
Harvey, R. (2009) '''A colour handbook of skin diseases of the dog and cat''' ''Manson Publishing''
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[[Category:To Do - Helen]]
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[[Category:To Do - Review]]
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{{review}}
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[[Category:Dermatological Diseases - Dog]]
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[[Category:Expert Review - Small Animal]]
 
[[Category:Integumentary System - Physical Damage]]
 
[[Category:Integumentary System - Physical Damage]]
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