Page 1313 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

1288 CHAPTER 12

VetBooks.ir ‘GREASY HEEL’ SYNDROME aspect of the pastern, but with time and poor
management it may extend up to the fetlock and
Definition/overview
crusting, alopecia and vasculitis lead to ulceration.
This is a loose conglomeration of diseases that have around the front of the limb. Erythema, oozing,
a clinically similar presentation of scaling, crusting With time and many varied medications, the skin
and erosion, with pyoderma of the pastern and heels. becomes thickened and develops fissures and a
It can be associated with lameness. true dermatitis. Lesions are painful and lameness
occurs. Severe chronic lesions may lead to chronic
Aetiology/pathophysiology granulation tissue.
Only one pastern, frequently a hindlimb, is usually
involved and it may also be ‘white-socked’. Greasy heel Differential diagnosis
syndrome is a reaction pattern and not a specific disease • Contact dermatitis involving primary
entity. Predisposing factors are mud, moisture, contact irritant or allergic contact dermatitis: irritant
hypersensitivity, insect bites and potentially minor substances on pastern, allergic contact (clover);
small traumas. Secondary infection with either bac- all four extremities are usually involved
teria (staphylococci, Dermatophilus) or dermatophytes (Fig. 12.93).
(Trichophyton spp., M. gypseum) is common. Chorioptes • Pastern folliculitis/pyoderma infections:
infestation can be a primary aetiology but can also be a staphylococcal infections (Fig. 12.94);
concurrent condition in a variety of inflammatory skin dermatophilosis (Figs. 12.95, 12.96);
conditions of the horse’s pastern region. dermatophytosis, which is rare and usually due
to M. gypseum or Trichophyton spp.; Fusiformis
Clinical presentation infection (plus infection in liver) (Fig. 12.97).
Many similarities exist among the different causes. Culture or PCR is needed to identify these
The condition usually starts at the posterior infections.

12.93 12.94

Fig. 12.93 Contact
dermatitis with scurf,
coronitis and chronic
granulation tissue at
the back of the pastern.

Fig. 12.94
Staphylococcal
infection in a 3-year-old
Thoroughbred with
skin erosion, alopecia
and involvement of the
back of the heel.