Skin Blisters and Pustules in Dogs

Skin blisters and pustules can cause much anxiety for your pet. Prompt diagnosis of the reason for the outbreak is necessary to prevent the skin condition from getting out of hand. Your dog may exhibit the following signs and symptoms indicating a serious problem with the epidermis:

• Warm, humid areas, such as folds in the neck, may appear red and ulcerated
• Pressure points, like the elbow, may have welts or scabs
• Ulcers can also emerge around the eyes, in the ears, and on the footpads, anus, groin, or axillae (armpits)
• Blisters can develop in the mouth and also on the skin around the nails
• There may be scaling of the skin, hair loss, or bald patches
• Yellow pustules or sacs of fluid may secrete blood or pus and turn crusty
• There might be an odor no matter how much you clean the area
• Your dog may display signs of pain
• Depression
• Lack of appetite
• Fever
• Pruritus (inability to resist licking, scratching, or attempts at self-harm in an effort to stop the irritation and itch)

Types

Skin blisters and pustules can appear in an acute form, and may at times resolve (for a short period) on their own. In all cases, treatment is recommended in favor of resolution because a skin condition can lead to life-threatening circumstances. Additionally, removing the cause of the problem is necessary for a cure or control of the condition.

• Pyodermas
• Caused by a bacterial skin infection
• Presence of yellow pustules that can ooze and itch
• Mostly found on the trunk area, obese dogs and Pugs are predisposed to infection in skin folds
• Also found on toes, callouses on feet, and the abdomens of puppies
• Not contagious to other pets or to humans

• Skin Fold Dermatitis
• Bulldogs are prone
• Skin becomes red and oozy
• Irritation is found on the lips, face, and vulva
• May progress with severe complications if left untreated

• Cutaneous Lymphoma
• This is a rare type of skin cancer
• Displays with itching ulcers, redness, and nodules
• Unfortunately this skin condition usually does not respond to treatment

Autoimmune Skin Conditions

• Pemphigus Foliaceus
• Akitas are prone
• The skin around the nails can be affected
• Ulcers may also be found in the ears, eyes, footpads and groin

• Pemphigus Vegetans
• Presents with chronic oozing and pus
• Is more prevalent warmer sunny climates
• Sun is a potential trigger

• Pemphigus Vulgaris
• Appears with fluid-filled blisters
• Become open sores as the blisters rupture easily
• Found in mouth, nostrils and around anus

• Pemphigus Erythematosus
• There will be scaling of skin
• Irritation begins with redness and crusty patches
• There may be hair loss specifically on nose

• Bullous Pemphigoid
• Presents with welts first
• Next stage is sacs of clear fluid
• Can be very itchy
• The most common places it is found are the mouth, axillae (armpits) and groin

Skin blisters and pustules can occur for a variety of reasons, some of which are listed below:

• Staphylococci bacteria over colonizes
• Warm, moist areas can develop a high bacteria count
• Skin conditions can be secondary to allergies or parasites
• In the case of an autoimmune disease, the body attacks the immune system
• Healthy cells are mistakenly attacked resulting in separation of skin
• Pyodermas can result from damage to the skin like tumors, urine scalding or bite wounds
• Medications for illnesses such as liver disease or cancer can cause an immunosuppression that leads to a skin condition
• Genetics may play a role in problems with the epidermis

The diagnosis of skin blisters and pustules can be complex. Identification of the underlying cause is paramount to the resolution of the skin issue. The veterinarian will need a complete history, as detailed as possible, in order to begin the diagnostic process. The veterinary specialist will want to know the following information:

• Specifics on your pet’s diet (brand of food, treats)
• Medications your dog may be taking
• Grooming products used (bring labels for analysis)
• Recent illnesses
• Travel history

The appearance and location of the blisters or pustules can provide a clue to the type of skin condition. However, the veterinarian will also need to perform certain tests to definitively diagnose the lesions. To begin, it is possible that blood tests and allergy tests will be ordered.

A skin biopsy may be done. It is called a punch biopsy and involves taking a small round block of skin. The biopsy may be done using a local anesthetic, but if your dog is nervous or stressed, or if the biopsy involves the face or nose, sedation or a general anesthetic will be suggested.

Another diagnostic tool is immunofluorescence, which is a light microscopy technique that can detect specific target antigens (substances that cause your immune system to produce antibodies against it). Needle aspirate cytology used to examine cells, and skin scraping, in order to exclude causes like parasites, may be done.

Culturing the skin, in an attempt to grow and identify bacteria, along with a fungal culture and adhesive tape prep (to examine cells, yeast or other abnormalities under the microscope) are additional tests that may be performed.

Treatment will involve the resolution of the underlying cause if needed, as well as a variation of methods depending on the type of skin condition.

In the case of an autoimmune issue, corticosteroids, which are drugs that lessen the efforts of the immune system to attack, will be given along with other immunosuppressant medications. It should be noted that depending on the skin condition; some immunosuppressants can be given during flares only, once the initial problem is under control. An autoimmune related skin condition is rarely curable but may be managed quite well with medication.

In instances of pyodermas, 3 to 4 weeks of antibiotics will be prescribed. The antibiotics will be in oral and topical form. Bathing with a medicated shampoo 2 to 3 times a week is required, and in severe cases a daily bath may be vital to a positive outcome.

When a dog has an acute form of skin blisters and pustules in the folds of the skin, surgical correction might be considered. Surgical intervention to drain pustules can be an appropriate treatment also.

Included in the treatment protocol may be anti-inflammatories to reduce swelling and pain, acupuncture, light therapy or a dietary overhaul.

The recovery of a serious skin condition is never a quick process. For example, healing of pyodermas can take up to 8 to 12 weeks. However, a mild improvement should be evident within 14 to 21 days of the start of treatment. Recurrent cases are possible and sometimes will need a staphylococcal vaccine in order to see results.

Attention to grooming is essential. The services of a professional groomer should be sought out. Removal of hair, because of the likelihood of trapping bacteria, is key to avoiding a recurrence of the problem. Continual use of oral and topical antibiotics may be necessary for some time. The use of bandages or an Elizabethan collar could be recommended by the veterinarian to lessen the licking and biting that your dog might want to do.

With the use of corticosteroids for autoimmune related skin problems, you will need to be aware of possible side effects. Changes in appetite (decrease or increase), panting, increased drinking of water and thus, more urination, vomiting, and inactivity may be evident in your dog’s behavior. Consult the veterinarian promptly to address the side effects. Avoid direct sunlight with skin problems diagnosed in the pemphigus family of conditions.

Never stop antibiotics or ointments prematurely. Frequent check-ups with the veterinary caregiver are part of the recovery (may include blood tests and urinalysis to monitor side effects of the therapy), as is diligent skin care at home.