650 DISEASES/DISORDERS
Pathologic Findings
Nodular granulomatous to pyogranulomatous inflammatory reaction at the level of
the sebaceous glands (isthmus region of hair follicles).
Orthokeratotic hyperkeratosis and follicular cast formation; more prominent in long-
coated breeds.
Advanced: complete loss of sebaceous glands; perifollicular granulomas and fibrosis.
Destruction of entire hair follicle and adnexal unit rare.
THERAPEUTICS
Clinical signs may wax and wane irrespective of treatment.
Response may depend on severity of disease at the time of diagnosis; early diagnosis
and initiation of treatment prevents complete loss of sebaceous glands.
Akita: often more refractory to treatment; develop more severe secondary bacterial
folliculitis.
Drugs of Choice: Topical Therapy
Antibacterial and/or keratolytic shampoo: bathe once to twice weekly; follow with
conditioner or propylene glycol spray.
Propylene glycol: (1:1 with water); humectant; attracts water into the stratum
corneum: apply lightly daily or as a prebathing treatment to soften scale.
Baby oil: occlusive emollient; prevents transepidermal water loss; apply as a pre-
bathing aid in removal of adherent scale.
Topical fatty acid spot-on containing essential oils, smoothing and purifying agents,
vitamin E, and a bio-diffusing vector (Dermoscent Essential-6 spot-on, LCDA,
France).Topical products containing novasomes, spherulites, and/or phytosphingosine: slow
release augments emollients to increase epidermal hydration.
Drugs of Choice: Systemic Therapy
Cyclosporine 5 mg/kg PO BID: often best therapeutic option, may cause vomiting,
diarrhea, gingival hyperplasia, hirsutism, papillomatous skin lesions, increased inci-
dence of infections, nephrotoxicity (rare), and hepatotoxicity (infrequent).Cycline antibiotics: tetracycline 250 mg PO TID for dogs<10 kg; 500 mg PO TID
dogs>10 kg); doxycycline 10 mg/kg PO q24h; minocycline 5 mg/kg PO BID; often
administered with niacinamide 250 mg PO for dogs<10 kg and 500 mg PO for dogs
>10 kg.Isotretinoin 1–3 mg/kg PO BID initial dose: reduce to 1 mg/kg q24h after 1 month and
taper further and maintain as needed; teratogenic, may cause keratoconjunctivitis,
gastrointestinal signs, hepatotoxicity.Pentoxifylline 10 mg/kg PO BID to TID.
Essential fatty acid supplementation: reduces transepidermal water loss; may be sup-
plemented directly or by feeding diets formulated for joint mobility.