Equine Health Update EHU Vol 21 Issue 03 | Page 35

CPD Article | EQUINE • This represents an advanced stage but it can develop abruptly following trauma to any other form of the disease at any site. • No current treatment. • Very poor prognosis. • Fibrosarcoma, spindle cell sarcoma, neurofibromas and fibromas are probably variants of the sarcoid (similar in gross appearance to sarcoid but some have histologically distinct features). Histopathology findings Diagnostic investigation Histopathology • Biopsy. • Do not biopsy unless you can treat the lesion as soon as results available. Biopsy may àprogression of lesion to more aggressive form Confirmation of diagnosis Discriminatory diagnostic features • History and clinical signs. Definitive diagnostic features • Diagnosis on clinical grounds is reasonable, avoiding the need for biopsy which often triggers an exacerbation. The presence of several dermal tumors and changes that are consistent with one or more of the recognized types is probably highly supportive, but cases may be complicated by another condition altogether. • Biopsy is characteristic histologically, although sometimes pathologists are reluctant to commit themselves to the diagnosis if there are no epidermal components, however, this is unjustified and it should be entirely feasible to make the diagnosis from tissue that has no overt dermal or epidermal tissue. • Epidermal and dermal components. • The epidermis (where intact) is acantholytic and hyperkeratotic with characteristic epithelial pegs extending into the dermis. • Whorled fibroblasts and varying amounts of interstitial collagen. • Haphazard vascular patterns will differentiate fibroblastic forms from granulation tissue. • Mitotic rates and doubling times are very variable but the former is usually slow while the latter is slow. • Predominance of one component over the other depends upon type of sarcoid and degree of surface ulceration. Differential diagnosis Type I - Occult • Alopecia areata. • Dermatophytosis. • Hyperkeratosis/skin irritation, eg from tack rubs. • Ectoparasites. • Insect bites. Type II - Verrucose • Papillomatosis. • Hyperkeratosis. • Squamous cell carcinoma. • Habronemiasis. • Bacterial/fungal granulomas. • Cheloid scar. • Equine sarcoidosis. • Molluscum contagiosum. • Horse pox. • Volume 21 Issue 3 | September 2019 • 35