Acral lick dermatitis in cats, also known as neurodermatitis, is a stereotypical, self-manipulating behavior. A feline will continue a pattern of licking behavior with no apparent purpose. As the act of overgrooming causes a release of endorphins in the brain, the feline will continue the self-abusive pattern even after a painful skin granuloma appears on the skin’s surface. Acral lick dermatitis is often the result of stress or boredom in indoor cats, but felines often over-groom in response to an allergen or other dermal irritant, which requires a differential diagnosis. 

If your cat has red, ulcerated skin on her paws or flank, she could be suffering from acral lick dermatitis. Acral lick dermatitis is defined as an injury to the skin caused by self-manipulating; excessive licking. The act of excessive licking is often linked to an obsessive compulsive disorder, due to stress or boredom, but it can also be a clinical sign of an underlying condition. Once a wound (granuloma) appears, the feline will continue to groom the area, causing the skin to become infected, irritated and painful. In order to properly diagnose acral lick dermatitis, consultation with a veterinary professional is a must. 

The primary clinical sign of acral lick dermatitis in cats is the act of repetitive, pattern licking in one area of the body. Due to the convenient location, lick dermatitis is commonly found on the feline’s carpal joints (wrist) or paws of the front limbs. Cat owners will note red, moist, irritated sores on the skin and localized hair loss. As the behavior continues, these sores can develop into granulomas. A granuloma is a pink, hairless and fleshy mass that often causes the skin to thicken.

True acral lick dermatitis in cats is a neurological, obsessive disorder that has arisen from boredom, stress, and inactivity. A feline that does not receive daily stimuli, such as play or hunting, will look for a way to entertain herself. The act of grooming releases endorphins (happy hormones) in the brain and fills the needs for activities. However, lick dermatitis can also be a self-manipulating behavior caused by allergies (ingested, contact, or inhaled), trauma, neoplasia, and fungal, or bacterial infections. 

Acral lick dermatitis in cats can easily be diagnosed on physical examination, as the lick granulomas are readily visible on the skin. In order to pinpoint the underlying cause of the self-manipulating, overgrooming behavior, a veterinarian will ask you a few questions about your cat’s lifestyle. Expect to be asked about your feline’s daily routine, when she plays, or if she gets time outdoors. The doctor will also ask you about any recent changes in the home, such as a new pet or baby, which may have stressed the feline. Cats are creatures of habit and can easily become distressed with change, so any information you have to offer is helpful in the diagnosis process. 

Acral lick dermatitis in cats can also be a clinical sign of an underlying health condition. In order to rule out other probable causes of acral lick dermatitis, your veterinarian will perform a diagnostic differential. Skin scraping, bacterial cultures, and histological examination of the skin is routine for ruling out external problems. To identify an internal health problem, the veterinarian may request radiographs to be taken, a urinalysis, and blood work on the feline.

The treatment of acral lick dermatitis in cats is variable and linked to the underlying cause. Bacterial skin infections that have caused or resulted from the act of overgrooming are treated with an antibiotic. Fungal infections of the skin are commonly treated with a topical antifungal cream applied to the affected area. A restrictive collar or bandage is often placed on the feline to prevent further destruction of the affected area in almost all cases, but neurologic causes of this condition are difficult to treat. Your veterinarian may prescribe an antianxiety or antidepressant drug to help alleviate the feline’s stress. He or she may also refer you to a feline behavioral specialist to specifically address the cause of the feline’s need to over groom.

Felines recover quickly from skin dermatitis once the area is treated, but the behavior often persists in the case of behavioral linked self-manipulation. Cat owners often find acral lick dermatitis to be a frustrated condition to manage, but your veterinarian can help you to correct the problem. Ensuring that your cat is receiving daily activities and mental stimuli are very important in treating acral lick dermatitis, but only when they are combined with the treatment plan put in place by your veterinarian.