Acral lick syndrome

Acral lick dermatitis, also known as a lick granuloma, holds an esteemed place in veterinary medicine as one of the most frustrating conditions we treat. There are a variety of triggers for the condition, but the result is the same: obsessive, repetitive licking of an area of skin, leading to infection and the characteristic skin lesion. We are all familiar with the classic clinical appearance; a raised, ulcerated granuloma typically on the top of the carpus or metacarpus, or less commonly the tarsus or metatarsus. The lesion initially starts small, but constant licking leads to lichenification, fibrosis, alopecia, furunculosis and ulceration. There are breed predispositions, with Doberman pinschers, Labrador retrievers, golden retrievers, boxers, Weimaraners, German shepherd dogs and Irish setters being over-represented. There are a variety of triggers for lick granulomas, including allergy, parasites mites , arthritis, neuropathy, foreign body, previous trauma or injury, metabolic hypothyroidism , or behavioral causes such as boredom, stress, or anxiety.
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Acral Lick Granuloma in Dogs

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Acral Lick Granuloma in Lacey, WA | Dermatology Clinic for Animals

Favoured sites for the excessive compulsive licking, which produces the lesion, are most commonly on the anterior carpal or metatarsal skin. The problem tends to occur in middle-aged to older breeds such as the Doberman, Great Dane, Golden Labrador, Labrador retriever, German shepherd and Boxer, although it may occur in other breeds including crossbreeds. It is suggested that differential diagnosis rule-outs are investigated before considering psychogenic underlying causes. An additional complication is that even if the original cause is psychogenic, secondary infection is very common and will need to be treated before further evaluation. The list of possible psychological causes cited here has not changed from that in previous editions of a standard text in the last 20 years or so of previous editions. The treatment of the lesion will depend on how long it has been present and what stage has been reached. Acral lick dermatitis has multifactorial causes and some aspects are still poorly understood.
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Acral Lick Dermatitis

It is frequently the result of incessant licking in one area of the body; quite often, the front legs. This is a common problem for dogs, and the cause varies. Acral licks can occur secondarily to allergies, injury, arthritis , infection, or certain stresses—even boredom.
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Lick granuloma LG also known as acral lick dermatitis or acral pruritic nodule; acral meaning 'extremity' is a common canine dermatitis wherein repetitive licking results in the development of a well circumscribed, raised, firm, alopecic, eroded to ulcerated plaque or nodule. Lesions are most commonly found on the dorsal aspect of the front limb, anywhere from the metacarpal area to the elbow. LGs are less commonly noted over the metatarsus or tarsal or tibial regions. The etiology of LG is multi-factorial. Primary factors are defined as those that initiate the licking.
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