Visiting Veterinarian

Tag, you're it

By Michele Gerhard Jasny V.M.D. - February 16, 2006

A few years back I had a little lesion on my face. I like the word "lesion." It sounds so official. It looked like a tiny crater in my cheek that wouldn't heal. I went to the dermatologist to check it out. Dr. Bigby agreed a biopsy was in order, but he assured me it was probably just a "dilated pore of Weiner." That sounded even more official than "a lesion," and a helluva lot more reassuring than "little hole in your cheek." So when people bring pets to me with common minor conditions, I try to remember that putting an impressive medical name to something benign but funny-looking may have a calming effect on an owner's fears.

Let's start with those little skin tags hanging off of your old mutt, Methuselah. They come in a variety of shapes and sizes and usually attach by a skinny stalk. They range in size from tiny to maybe an inch long. They may be pink or pigmented black. They are most common on the underside of the chest, the sides of the body, and along bony prominences like the elbows, but can occur anywhere. Skin tags are benign and no treatment is necessary unless they are repeatedly being traumatized or are cosmetically unacceptable. If we do remove one and send it to a pathologist for a biopsy, the report will read something like this: hyperplastic epidermis overlying a core of vascularized caliginous connective tissue. These growths are not cancerous, but if "skin tag" is not official enough, they can be called fibrovascular papillomas.

Another unusual growth we see once in a while is a cutaneous horn, a cylindrical or conical mass of keratin. Keratin is the stuff that toenails are made of, and these lesions can look exactly like an extra nail growing in the wrong place. Usually small, less than an inch in length, the horns themselves are benign, and most frequently occur on the footpads. They can occasionally be associated with serious underlying causes, so in some cases your veterinarian may recommend surgical removal. In cats, an association with Feline Leukemia Virus infection has been reported, so a blood test may be warranted. I can 't find a fancier name in any of my texts, but most owners seem content with "cutaneous horn" as it so clearly describes this unique condition.

Nosing around
What about your old cocker spaniel's nose, the way it's all lumpy, cracked, and thickened? Maybe it's got some scabby crusts or you've noticed similar changes on his footpads. Although there are several serious diseases that can appear like this, by far the most common cause is idiopathic nasodigital hyperkeratosis. OK. That's not really a cause. It's a description. Idiopathic means we don't know why it happens. Nasodigital means it affects the nose and toes. Hyperkeratosis means it's got extra keratin. In other words, his nose is crusty and thickened for no known reason. Idiopathic nasodigital hyperkeratosis is most common in older dogs, particularly spaniels. Blocked tear ducts causing a dry nose may be a contributing factor, and flushing these ducts may lessen the problem. If the nose has a lot of deep cracks or sores, your veterinarian may suggest a biopsy to rule out autoimmune diseases like discoid lupus erythematosis or pemphigus foliaceus, which require specific treatment. Once these diseases are ruled out, you can relax and treat that nose symptomatically by soaking with warm water and applying softening agents like petroleum jelly, A & D ointment, or Bag Balm. If your pup is a young Labrador instead of an old cocker and showing similar symptoms, he may have "hereditary nasal parakeratosis of Labrador retrievers." This recently described syndrome is inherited and looks pretty much the same as idiopathic nasodigital hyperkeratosis, except for the earlier age of onset and the breed specificity. Treatment is similar. Young Labs with this condition should not be bred, as it may be passed on to their offspring. The condition is not life-threatening but also not curable, requiring ongoing therapy to keep symptoms to a minimum.

Speaking of noses, anyone out there have a Labrador whose nose is fading to light brown or pink? As long as the nose doesn't seem irritated, don't worry. It's probably just "snow nose." If that label is too folksy, the technical term is "nasal depigmentation." It's another idiopathic condition that is primarily cosmetic, not medical. Nasal depigmentation tends to come and go, and may be seasonal, occurring most frequently in the winter. Commonly affected breeds include golden retrievers, yellow Labradors, Siberian huskies, and Alaskan malamutes. If the depigmentation is permanent, it may be a different condition dubbed "Dudley nose," after a famous bulldog named Lord Dudley who had a pale liver-colored nose. In the late 1800's, when Lord Dudley reigned, this was not considered a defect, and he sired many progeny. Today, Dudley nose is used to describe a permanent pigment defect in many different breeds in which the nose is "flesh-colored." (Some dog breeders have apparently not caught up with Crayola crayons and Bandaids in correcting this Eurocentric terminology. My apologies.) Dudley nose is generally considered a flaw. The AKC standards for Labradors states that yellow and black labs should have black noses and that chocolate Labs should have brown noses, but then adds "nose color fading to a lighter shade is not a fault. A thoroughly pink nose or one lacking in any pigment is a disqualification." That's a disqualification from breeding and showing, not from winning your heart. Personally I don't care what color my dog's nose is, so long as it's healthy and giving me kisses.

Not to worry
How about the cats? Kitty owners often express concern about those flat black spots on some cats' lips, eyelids, or ear margins. It's called lentigo, and is completely benign. It is most common in orange cats and does not require treatment. Kitty owners also obsess about that patch of sparse hair that spans the area between the eye and ear. If there is excessive itching or little red scabs, then we have to consider parasitic and fungal infections, as well as allergies, but if the skin looks healthy then this is a simple case of feline preauricular alopecia. It's normal.

I could go on. If you're not sure what something is, have a medical professional check it out. I recently had a friend worried about a lump in the middle of her chest. I remember having had the same scare and going to my family physician. Dr. Nieder laughed and reassured me gently that it was the normal end of my sternum. "Have your doctor check it out," I told my friend, "but that's all it is." By the way, I looked it up . . . it's called the ensiform or xiphoid appendix. It's normal. And the lesion on my cheek? A dilated pore of Weiner.