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26 Acute Moist Dermatitis

Acute Moist Dermatitis Client Education
Sheet
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BASIC INFORMATION
Differential Diagnosis • Systemic glucocorticoids (e.g., prednisone
0.5-1 mg/kg PO q 24h): recommended for
Definition • Demodicosis extensive or very painful lesions; treatment
A common, acute, and rapidly progressive • Dermatophytosis duration depends on severity of lesion but
exudative dermatitis associated with self-trauma • Pyoderma typically is 5-10 days.
from an underlying pruritic or painful condition • Calcinosis cutis • Nonsteroidal antiinflammatory drugs (e.g.,
meloxicam 0.1 mg/kg PO q 24h for 3-5
Synonyms Initial Database days): alternative for pain management; do
Hot spot, moist eczema, pyotraumatic dermatitis • Skin scrapes: negative for mites (p. 1091) not administer in conjunction with systemic
• Impression of cytologic examination: bacterial glucocorticoids
Epidemiology colonization Oclacitinib (0.4-0.6 mg/kg q 12h for 5-7 days
SPECIES, AGE, SEX • Systemic antibiotics (e.g., cephalexin
Acute moist dermatitis is most common in Advanced or Confirmatory Testing 22-30 mg/kg PO q 12h for minimum of
dogs < 4 years old and rarely diagnosed in cats. Skin biopsy: indicated only in poorly responsive 21 days): indicated if erythematous papules
or recurrent lesions are noted at periphery of lesion
GENETICS, BREED PREDISPOSITION
Any breed, but golden retrievers, Labrador TREATMENT Recommended Monitoring
retrievers, Saint Bernards, and German shep- Re-evaluation in 5-7 days is recommended for
herds are overrepresented. Treatment Overview extensive lesion or if lesion is not resolving
• Clip and cleanse lesions; sedation and with appropriate therapy.
RISK FACTORS analgesia is often required.
Hot, humid weather is a risk factor. Dense- • Control inflammation and pruritus. PROGNOSIS & OUTCOME
coated, long-haired breeds have increased risk. • Identify and control or resolve underlying
Other factors associated with acute moist der- causes. • Most lesions respond rapidly and completely
matitis include allergy (flea, atopic dermatitis, to topical and/or systemic therapy.
adverse food reaction, contact), ectoparasites, Acute General Treatment • Acute moist dermatitis will recur if predispos-
insect bites, otitis externa, anal sac disease, excess • Sedation or general anesthesia is warranted ing causes have not been eliminated or
moisture (e.g., swimming), unkempt coat, and in some cases (when patient shows signs of controlled.
painful musculoskeletal disease (recumbency). intense pain at rest or often during initial
approach to clipping of hair or cleansing of PEARLS & CONSIDERATIONS
Clinical Presentation lesion) (see the back inside cover).
HISTORY, CHIEF COMPLAINT • Clip hair from lesions to allow cleaning and Comments
• Acute onset of well-demarcated red, moist, easier topical treatment. • Whenever an acute moist dermatitis lesion
and alopecic area that exudes serum and • Gently but thoroughly flush area with responds poorly to appropriate therapy or
becomes matted with hair, especially at the an antiseptic solution such as diluted relapses quickly, an alternative diagnosis
periphery chlorhexidine solution to remove exudate and should be considered. Skin biopsy may be
• Lesion is often intensely pruritic, very painful, crusts. indicated.
and often enlarges rapidly (minutes-hours). • Topical therapy: often sole therapy warranted • Papules and pustules surrounding an acute
with small lesions. Apply astringent (2% moist dermatitis lesion (satellite lesions)
PHYSICAL EXAM FINDINGS aluminum acetate solution) topically q 8-12h may indicate a primary follicular infection
• Various sizes of erosive to ulcerative lesion for 3-7 days; more extensive or painful lesions (pyotraumatic bacterial folliculitis and
exuding serum benefit from topical glucocorticoid cream furunculosis), where the dog traumatizes the
• Erythematous margins sharply demarcate or combination steroid/antibiotic topical skin in the area of a pre-existing bacterial
lesion from surrounding normal skin. cream or gel applied q 12h for 5-7 days. infection.
• Erythematous papules at periphery of lesion
suggest deep pyoderma.
• Lesions most frequently found on face, neck,
dorsal lumbosacral area, and lateral thighs.
• Single lesion in one body region more is
common than multiple lesions.
Etiology and Pathophysiology
• Any factor that initiates an itch-scratch cycle
may predispose to acute moist dermatitis.
• Pyotraumatic lesions may become sec-
ondarily infected, leading to pyotraumatic
folliculitis.
DIAGNOSIS
Diagnostic Overview
The diagnosis is almost entirely based on the ACUTE MOIST DERMATITIS Acute moist dermatitis (center) in a dog with atopic dermatitis. The lateral
history and characteristic skin lesion. thorax was clipped for intradermal skin testing (lower left). (Courtesy Dr. Jocelyn Wellington.)

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