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Skin Bumps (Granulomatous Dermatoses) in Dogs

Sterile Nodular/Granulomatous Dermatoses in Dogs

Granulomatous dermatoses in dogs refer to conditions characterized by the presence of sterile nodules or masses in the skin, typically larger than one centimeter in diameter. These nodules form due to an accumulation of inflammatory cells within the skin, which can be triggered by internal or external factors.

Symptoms and Types

  • Nodular dermatofibrosis commonly occurs in German Shepherds aged 3–5 years.
  • Calcinosis circumscripta typically affects German Shepherds younger than two years old.
  • Malignant histiocytosis is frequently observed in Bernese Mountain Dogs.
  • While these conditions may affect dogs of any age, breed, or gender, Bernese Mountain Dogs have a higher predisposition to malignant histiocytosis, and German Shepherds are more prone to nodular dermatofibrosis.

Causes

  • Amyloidosis: Deposits of waxy protein known as amyloid in the body.
  • Reaction to foreign bodies.
  • Spherulocytosis: A disorder affecting red blood cells.
  • Idiopathic sterile granuloma and pyogranuloma.
  • Canine eosinophilic granuloma: Infiltration of eosinophils from the blood into the skin.
  • Calcinosis cutis: Skin condition associated with Cushing’s disease in dogs.
  • Calcinosis circumscripta: Formation of skin stones similar to calcinosis cutis.
  • Malignant histiocytosis: Abnormal spread of immune-type cells.
  • Cutaneous histiocytosis: Spread of immune-type cells to the skin.
  • Sterile panniculitis: Inflammation of the skin.
  • Nodular dermatofibrosis: Formation of bumps filled with excess elastic skin material often accompanying kidney disease.
  • Cutaneous xanthoma: A benign skin issue involving immune cell infiltration, usually associated with hyperlipoproteinemia or diabetes mellitus.

Diagnosis

Your veterinarian will conduct a comprehensive physical examination of your dog, including a blood chemical profile, complete blood count, electrolyte panel, and urinalysis. It’s important to provide a detailed history of your dog’s health leading up to the appearance of symptoms.

The physical examination will involve a thorough dermatologic assessment, and skin biopsies may be taken for histopathological analysis to determine any structural changes in the tissue. Additionally, skin scrapings will be examined under a microscope and cultured to detect the presence of bacteria, mycobacteria, and fungi.

Treatment

Many of these skin disorders can be managed on an outpatient basis unless they have progressed to a severe stage. However, certain conditions like malignant histiocytosis, amyloidosis, and nodular dermatofibrosis are often fatal.

For dogs with calcinosis cutis, hospitalization may be necessary for sepsis management and intensive topical therapy.

Here are specific treatments for some forms of dermatoses with nodules or granulomas:

  • Amyloidosis: Therapy options are limited, unless the lesion is solitary and can be surgically removed.
  • Spherulocytosis: Surgical removal is the primary treatment.
  • Foreign body reactions: Removal of the offending substance is the best approach whenever possible. Hair foreign bodies may require softer bedding and topical therapy with keratolytic agents. Secondary bacterial infections may necessitate treatment with both topical and systemic antibiotics.
  • Malignant histiocytosis: Unfortunately, there is no effective therapy, and the condition is rapidly fatal.
  • Calcinosis cutis: Management involves controlling the underlying disease if possible. Most cases require antibiotics to address secondary bacterial infections. Hydrotherapy and frequent bathing with antibacterial shampoos can help minimize secondary problems. Close monitoring of serum calcium levels is important in extensive cases.
  • Calcinosis circumscripta: Surgical excision is typically the preferred treatment.
  • Sterile panniculitis: Surgical removal is an option for single lesions.
  • Nodular dermatofibrosis: In most cases, there is no specific therapy available because cystadenocarcinomas are usually bilateral. However, for rare unilateral cases of cystadenocarcinoma or cystadenoma, removal of the affected kidney may be beneficial.
  • Cutaneous xanthoma: Treatment involves addressing the underlying diabetes mellitus or hyperlipoproteinemia, which is usually curative.

Living and Management

Your veterinarian will prescribe medication based on your dog’s diagnosis and overall condition. If your dog requires long-term glucocorticoids, regular monitoring through bloodwork and urinalysis every six months is necessary. For dogs undergoing treatment with dimethylsulfoxide for calcinosis cutis, bloodwork should be conducted every 1-2 weeks to monitor calcium levels until they stabilize.

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