Equine Health Update EHU Vol 21 Issue 03 | Page 32

EQUINE | CPD Article is no/little hair cover and where flies feed without hindrance. • It has been suggested that sarcoid lesions tend to occur on areas of skin prone to traumatic insult. • Wounds are a common site for sarcoid transformation - wound healing is delayed/ inhibited and complexes with granulation tissue and sarcoid admixtures are common. Sarcoid should be considered whenever there is incipient and unexplained wound healing failure - there is little clinical difference between granulation tissue (proud flesh) and sarcoid. Pathophysiology • Occasional tumors exacerbate rapidly, especially after traumatic damage, including biopsy. This may be because incomplete excision activated latent BPV which stimulates sarcoid growth. • Epidemiology • Flies have been suggested to be involved in the transmission of an etiologic agent. • This corresponds with the concept that sarcoids multiply on an individual horse over the summer and grow over the winter to become visible in the following spring and summer. Diagnosis Client history • Locally invasive, non-metastasizing, fibroblastic tumors of the skin with a spectrum of clinical presentations. • Capacity for infiltrative expansion in the dermis and subcutis. • Metastatic spread does not occur, but some reports of multiple small lesions occurring after incomplete surgical removal of one sarcoid or after autogenous vaccine usage. • Malevolent form shares some characteristics with aggressive, locally invasive neoplasms. • Fibroblastic types have long sinuous pegs of tumor tissue extending beneath the intact epidermis. • High tendency for sarcoids to recur. • Six distinguishable types (see under clinical signs). • Lesions commonly seen on head (periorbital, lips and muzzle), ventral abdomen and thorax, especially paragenital area and axillae, and less frequently on the limbs and upper body trunk/ dorsum. • Lesions may worsen following iatrogenic or other trauma, including biopsy. • Sarcoid transformation of wounds may interfere with wound healing. • Horses with sarcoids require special sound management procedures to avoid sarcoid transformation and subsequent incipient wound healing failure. Clinical signs Timecourse • Lesions tend to persist; some static, some worsen over time. • Spontaneous resolution is very rare (<1%). • May recur years after apparently successful removal. 32 Type I - Occult sarcoid • Common around the mouth, eyes, neck and other relatively hairless areas of the body, including the eyelids, face, inside of antebrachium, axilla and thigh. • Well defined, commonly roughly circular, area of alopecia or altered hair density and character • Equine Health Update •