Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland.
Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
J Am Vet Med Assoc. 2023 Mar 17;261(S1):S58-S65. doi: 10.2460/javma.22.12.0569. Print 2023 Jun 1.
Equine pastern dermatitis (EPD) is a nonspecific cutaneous reaction pattern on the distal extremities, typically in the palmar/plantar area of the pastern. Although EPD is commonly seen in equine practice and can be a debilitating condition, peer-reviewed original studies on many aspects of this multifactorial syndrome are still scarce. This narrative review aims to give an overview of the clinical presentation (forms of EPD and clinical scores and differential diagnoses), risk factors, and therapeutic approaches. The emphasis is on intrinsic and extrinsic risk factors as most of the original work has been published on these aspects. The available data supports the effects of age, breed, and breed-related phenotypical traits (draft breeds with feathers and large cannon circumference) on the frequency and severity of EPD manifestations. Hind legs and unpigmented limbs are also more frequently affected. Genetic effects in draft breeds appear to be complex, and no commercial genetic tests currently exist. Evidence for meteorological effects like rainfall and humidity is inconclusive. Associations with Chorioptes infestation and bacterial microbiota imbalances but not with fungal infections have been consistently shown. Causality has not been demonstrated for specific infectious agents. Original studies have investigated the effects of antibacterial agents (Kunzea oil, phytosphingosines, and triclosan), fatty acids, aromatic oils, and humectants as well as therapeutic approaches to Chorioptes infestation in EPD-affected equids. While therapy remains largely empirical, knowledge of investigated risk factors for this multifactorial syndrome can inform diagnostic and therapeutic approaches. Raising owner awareness of EPD could be key to improving the welfare of affected horses.
马蹠皮炎（EPD）是一种发生在四肢末端的非特异性皮肤反应模式，通常发生在跗关节的掌侧/跖侧区域。尽管 EPD 在马临床上很常见，并且可能是一种使人虚弱的疾病，但对于这种多因素综合征的许多方面，仍缺乏同行评议的原始研究。本综述旨在概述临床表现（EPD 的形式和临床评分以及鉴别诊断）、风险因素和治疗方法。重点是内在和外在风险因素，因为大多数原始研究都集中在这些方面。现有数据支持年龄、品种和与品种相关的表型特征（具有羽毛和大炮管周长的役用品种）对 EPD 表现的频率和严重程度的影响。后腿和无色素的四肢也更容易受到影响。役用品种的遗传效应似乎很复杂，目前尚无商业性的遗传检测。关于降雨和湿度等气象影响的证据尚无定论。已一致表明与 Chorioptes 感染和细菌微生物群落失衡有关，但与真菌感染无关。尚未证明特定的传染性病原体具有因果关系。原始研究已经调查了抗菌剂（Kunzea 油、植物鞘氨醇和三氯生）、脂肪酸、芳香油和保湿剂以及针对 EPD 受影响的马的 Chorioptes 感染的治疗方法的效果。虽然治疗方法在很大程度上仍然是经验性的，但对这种多因素综合征的已调查风险因素的了解可以为诊断和治疗方法提供信息。提高所有者对 EPD 的认识可能是改善受影响马匹福利的关键。
