Feline Acral Lick Granuloma Study Guide

Overview and Clinical Importance

Acral lick granuloma (ALD), also known as acral lick dermatitis or neurodermatitis, is a self-induced skin lesion caused by chronic, repetitive licking of a focal area on the distal extremities. While this condition is much more commonly encountered in dogs, it can occasionally occur in cats and represents an important differential diagnosis for feline dermatologic presentations on the NAVLE. The term acral refers to the extremities (legs and feet), indicating the characteristic location of these lesions.

In cats, this condition is often associated with underlying medical conditions, behavioral disorders, or a combination of both. Understanding the multifactorial nature of feline acral lick granuloma is essential for accurate diagnosis and successful treatment. The condition creates a self-perpetuating itch-lick cycle that can be challenging to break without addressing all contributing factors.

Etiology and Pathophysiology

The Itch-Lick Cycle

The pathogenesis of acral lick granuloma involves a self-perpetuating cycle that becomes increasingly difficult to break as the condition becomes chronic. The cycle begins when an initiating factor (pruritus, pain, or behavioral trigger) causes the cat to begin licking a specific area. Constant licking causes hair loss and erosion of the superficial skin layers, leading to inflammation, secondary bacterial infection, and thickening of the skin. The damaged tissue releases endorphins, which provide temporary comfort and reinforce the licking behavior, creating a cycle of self-trauma that can become compulsive.