CHAPTER 23 EOSINOPHILIC DISEASE (GRANULOMA) COMPLEX 353
Indolent ulcer (rodent ulcer): classically concave and indurated ulcerations with a
granular, orange-yellow color, confined to the upper lips adjacent to the philtrum;
secondary infection common (Figures 23.12, 23.13).Allergic miliary dermatitis: multiple brown/black crusted and erythematous papules;
lesions more often palpated than visualized; may be associated with alopecia; usually
associated with pruritus; frequently affects the dorsum (Figures 23.14, 23.15).Dog
CEG: ulcerated plaques and masses; dark or orange color; most often affects the
tongue and palatine arches; also reported firm, nonpruritic, erythematous, alopecic,
and often ulcerative, dermal nodules on the digits, face (nasal planum, cheek, eyelid),
pinnae, flanks, and prepuce (Figures 23.16, 23.17).DIFFERENTIAL DIAGNOSIS
Includes the other diseases in the complex.
Herpesvirus – dermatitis.
FeLV- or FIV-associated dermatitis.
Unresponsive lesions:
Pemphigus foliaceus
Dermatophytosis or deep fungal infection
Demodicosis
Bacterial folliculitis
Neoplasia (especially metastatic adenocarcinoma, squamous cell carcinoma, and
cutaneous lymphosarcoma).
CEG (dog): neoplasia (mast cell tumor, lymphoma), histiocytosis, infectious granu-
loma (bacterial/fungal), insect/arthropod bite reaction, foreign body reaction, aber-
rant parasite migration, trauma.DIAGNOSTICS
Cat and dog: CBC: mild to moderate eosinophilia; serum chemistries and urinalysis
usually normal.
Cat: FeLV and FIV serum testing.
Diagnostic Procedures
Impression smears from lesions: large numbers of eosinophils (Figure 23.18); bacteria
commonly found with eosinophilic plaques and indolent ulcers.
Insect hypersensitivity: parasite control (especially flea) to assist in excluding flea or
mosquito bite hypersensitivity.
Cutaneous adverse reaction to food: restricted-ingredient food trial: challenge to
induce development of new lesions.