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Compendium

Applied Dermatology: Postcard Presentation: A Dog With Claw Atrophy

    Figure A.

    Figure B.

    Diagnosis:

    This patient has an acute case of onychitis (inflammation in the claw unit). Many diseases have been associated with claw abnormalities. In cases with a sudden onset of disease, involvement of multiple claws, and proximal claw distribution, a systemic disorder should be considered. In this case, no illnesses, medications, vaccinations, or changes in the patient could be associated with the onset of disease. Finding bacteria on cytology of inflamed tissue is common, but these bacteria are rarely the cause of the disease, and therapy with antibiotics is not curative and is rarely helpful. Interpretation of histopathologic findings in these cases is important but can be of minimal diagnostic value. Despite varying clinical presentations, most biopsy samples reveal a lymphocytic interface dermatitis with hydropic changes similar to those found in lupus erythematosus.1 For this reason, the disease symmetric lupoid onychodystrophy has been described.1

    In this case, idiopathic onychomadesis of the proximal claw was diagnosed.

    Therapy:

    Prophylactic trimming of loose or lifted claws was performed. Despite not having the typical clinical signs of symmetric lupoid onychodystrophy, the patient was started on a combination of tetracycline and niacinamide with omega-3 and omega-6 fatty acids and rechecked monthly. Within 2 weeks, the patient was less painful and more playful, and within 2 months, the proximal claw was regrowing. The claws were fully grown out and functional within 7 months. There was some longitudinal ridging on the claws, but they were not malacic. The course of therapy was continued for 12 months. In cases with a longer history before starting therapy, there can be marked changes to the claw bed (corium), and surgical onychectomy may be the best treatment option.

    Reference

    1. Scott DW, Rousselle S, Miller WH Jr. Symmetrical lupoid onychodystrophy in dogs: a retrospective analysis of 18 cases (1989-1993). J Am Anim Hosp Assoc 1995;31(3):194-201.