Dog: Lick Granuloma

General information

Other common/scientific names: acral lick dermatitis (ALD), psychogenic dermatoses

A lick granuloma or ALD is a common, psychogenic (mental) condition seen in large, active dogs which lick an area excessively, usually a front leg. These dogs are obsessive about licking a certain area. The chronic licking causes a raised, thickened, firm ulcerated area known as a granuloma. These areas are prone to infection which makes them itchier causing more licking and inflammation and perpetuating the cycle.


Lick granulomas can be caused by stress, lack of exercise, separation anxiety, boredom, conflict with another pet or lack of interaction with people. In some cases, licking can be caused by a transitory insult, a skin disease or pruritis caused by atopic dermatitis or flea dermatitis. While the term lick granuloma may be used in these conditions, they are not psychogenic and are discussed in other articles. High strung, large breed dogs such as Labrador Retrievers, Irish Setters, Doberman Pinschers and Great Danes are more prone to this condition.

Cardinal symptom



A raised, firm ulcerated mass is seen most commonly on the wrist or forearm. Chronic areas become hard and thickened with hyperpigmented surrounding skin. Arthritis may be associated with long-standing granulomas from chronic trauma.

Abb. GSHCJXV8: Lick granuloma.


Diagnosis of a lick granuloma can be made from a physical examination. Identifying the cause and treating the perpetuating issues can be challenging. A thorough history must be obtained from the owner. A skin scraping and fungal cultures should be performed to rule out ectoparasites and dermatophytosis (ringworm). A skin biopsy is used to classify the cells in the granuloma, aiding in both the diagnosis and treatment. A culture and sensitivity may be needed to indentify and treat a chronic infection.


The motivation for a psychogenic lick granuloma is psychological, not physical. So, while many treatments offer symptomatic relief, for therapy to be successful, the mental issue must be addressed. This includes allowing ample exercise, addressing separation anxiety, watching for discord between animals and providing human interaction. Medications used for treating human obsessive/compulsive disorders and serotonin-inhibiting medications have shown success for the anxious, high-strung dogs and are used when therapies fail.

Specific treatments for symptomatic relief include:


Lick granulomas can be extremely frustrating. Many cases require life-long management and medication.


Keeping your dog well exercised, providing companionship and reducing any environmental stresses can prevent lick granulomas.

Update version: 4/24/2014, © Copyright by
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