Lick granuloma also known as Acral lick dermatitis is a chronic skin condition caused by excessive licking of a particular part of the body. This excessive licking can lead to self-mutilation or trauma, the most commonly affected areas are the on the legs: on the top of the wrist, around the ankle, and on toes.

A lick granuloma starts by persistently licking one specific area of the body, while licking to groom is perfectly normal this obsessive licking results in injury to the skin. This injury results in pain or itch which results in further licking and itching, which leads to inflammation and infections causing, you guessed it right, more licking. Thus, setting up an itch and lick cycle, over a period of time the affected area forms a granuloma which scarily enough looks like a tumour. 

This condition is usually seen in middle to older dogs. Breeds most susceptible are- Labrador Retrievers, Doberman Pinschers, Great Danes, Golden Retrievers, Boxers, Akitas, Dalmatians, Irish Setters, English Setters etc. The various causes of lick granuloma are- skin allergies or hypersensitivities, skin infections, joint issues, skin trauma, stress, anxiety, boredom and OCD.

Symptoms besides obsessive licking include hair loss in the affected area or alopecia, eroded or ulcerated skin from being licked so much, raised, reddened plaques or nodules, itching. Acral lick dermatitis usually only occurs in one area, in some cases, a dog can have multiple areas of the body affected.

Diagnostic tests involved are complete blood and serum analysis, skin scrapings, culture and sensitivity tests, allergy testing, orthopaedic and neurological examinations and biopsy of granuloma to rule out malignancy. Treatment may be customised to the cause of the granuloma, for bacterial infections antibiotics are prescribed, antifungal drugs are used for fungal infections, antihistamines can help break the itch cycle, food elimination trials can be done to treat allergic dermatitis. Besides these steroids, pain medication and supplements may be prescribed. In cases of behavioural issues or anxiety induced lick granulomas training, anti-anxiety medication, increased play and walk time, interactive toys and breaking the itch cycle using e-collars, bandages and t-shirts can prove to be effective. Behaviour induced lick granulomas are usually harder to treat and more common. 

The best way to prevent lick granulomas in dogs is to stop the problem before it starts. If you notice that your dog is licking one part of his body more than usual, talk to your veterinarian as soon as possible to avoid a little problem becoming bigger and harder to solve.