DOI: 10.1111/j.1365-3164.2010.00918.x
Skin diseases in the alpaca (Vicugna pacos): a literature
review and retrospective analysis of 68 cases (Cornell
University 1997 2006)
practicing veterinarian.1 4 Reviews exclusively devoted to
Danny W. Scott*, , Jeff W. Vogel*, Rebekah I.
Fleis , William H. Miller Jr*, and Mary C. Smith! alpaca skin conditions are not available in the literature.
Clinicians have to rely upon literature for the llama,5,6
or extrapolations from mixed camelid reviews,2,4,7 9 or
*Department of Clinical Sciences, College of Veterinary Medicine,
Cornell University, Ithaca, NY 14853, USA
information from scattered case reports.

Department of Biomedical Sciences, College of Veterinary
A postal survey was conducted in the UK between
Medicine, Cornell University, Ithaca, NY 14853, USA
2000 and 2001 by D Alterio et al.10 This survey indicated
!
Department of Population Medicine and Diagnostic Services,
that the percentage of alpaca ownership was increasing.
College of Veterinary Medicine, Cornell University, Ithaca, NY 14853,
In 1993, alpacas accounted for 21% of the camelid popu-
USA
lation, whereas in 1998 they accounted for 77% of the
Correspondence: Danny W. Scott, Department of Clinical Sciences,
College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, camelid population. In the same survey, 51.1% (111 of
USA. E-mail: [e-mail]
217) of respondents indicated that skin diseases were
Sources of Funding
seen at one time or another, and that up to 9% of all ani-
This study is self-funded.
mals could be affected at a given time. Most respondents
Conflict of Interest
reported that skin conditions were more prevalent in
No conflicts of interest have been declared.
summer, and that most affected animals were nonwhite
coloured.
Abstract
The most common skin lesions reported in the UK
survey were alopecia, crusts, scales and pruritus. The
This retrospective study describes 68 alpacas with
most commonly affected body sites were the nose, ears,
skin diseases investigated from 1997 through 2006 at
periorbital region, medial thighs, axillae, dorsum and
Cornell University. During this time period, 40 of 715
abdomen. The most common dermatological diagnoses
(5.6%) alpacas presented to the university hospital
rendered by attending veterinarians, as reported by the
had dermatological diseases. In addition, skin-biopsy
owners, were zinc-responsive dermatitis (23%), ectopar-
specimens accounted for 86 of 353 (24.4%) of alpaca
asitism (19%), fungal infection (3%), bacterial infection
biopsy specimens submitted to the diagnostic labo-
(3%), allergy (3%), dermatophilosis (2%) and contagious
ratory, and of these 86 specimens, follow-up was
viral pustular dermatitis ( orf ; 1%). This information must
available for 28 cases. The following diseases were
be carefully interpreted, as it is not known how the diag-
most common: bacterial infections (22%); neoplasms,
noses were established.
cysts and hamartomas (19%); presumed immuno-
The UK survey also indicated that many alpacas were
logical disorders (12%); and ectoparasitisms (10%).
housed on farms with other domestic species, as follows:
Conditions described for the first time included
horses and ponies, 66.7%; sheep, 55.9%; goats, 22.6%;
intertrigo, collagen and hair follicle hamartomas,
and cattle, 19%. This has obvious implications for the
lymphoma, hybrid follicular cysts, melanocytoma,
infectious and ectoparasitic diseases that can affect
anagen defluxion, telogen defluxion, presumed
those domestic species and alpacas. It is not known if
insect-bite hypersensitivity, ichthyosis, and possible
similar percentages of commingling of species occur in
hereditary bilateral aural haematomas and chondri-
the USA, but the practice is undoubtedly common.
tis. The results of the retrospective study are com-
In this paper we firstly review the literature (predomi-
pared and contrasted with the results of a literature
nantly English language) on alpaca skin conditions, sec-
review.
ondly present the results of a retrospective study of
Accepted 22 May 2010
dermatological disorders in alpacas examined at the
Cornell University Hospital for Animals (CUHA), and
thirdly present the results of a retrospective study of
alpaca skin-biopsy specimens submitted to the Animal
Health Diagnostic Center (AHDC) at Cornell University.
Introduction
Materials and methods
Alpacas (Vicugna pacos, formerly Lama pacos) are grow-
ing in popularity and are increasingly being presented for
From January 1997 through December 2006 (10 years), 715 alpacas
veterinary care and often present with skin disorders that were patients at the CUHA, and 40 of these (5.6%) had dermatologi-
cal diseases (Table 1). Follow-up information was available for 33
provide diagnostic and therapeutic challenges for the
2 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.
Skin diseases in the alpaca
(82%) of these patients. The number of alpaca patients per year
deciduous caps are loose but the permanent teeth are
increased from 18 in 1997 to 240 in 2006. The female:male ratios of
not fully mature, thus allowing for trauma from roughage
the total alpaca patient population and the dermatology cases were
during mastication.15
3:1 and 4:1, respectively. During the same time period, 86 skin-
Actinomyces spp. and unidentified anaerobes were the
biopsy specimens from alpacas were submitted to the AHDC. Fol-
most common isolates in one large study.15 Radiography
low-up information was available for 28 (33%) of these alpacas
is recommended to confirm the diagnosis and to evaluate
(Table 1). Skin-biopsy specimens accounted for 24.4% (86 of 353)
alpaca biopsy specimens submitted during the study period. the extent of osteolysis.15
Treatment usually includes combined tooth extraction
and systemic antibiotics.14,15 The two most successful
Case results and literature review
antibiotic regimens (in combination with tooth extraction)
Bacterial diseases were ceftiofur at 2.2 mg D kg once or twice daily, i.v. or
Bacterial infections (including dermatophilosis) accounted s.c., for a mean duration of 11.4 ą 5.5 days, or procaine
for only 5% of the cutaneous diagnoses made in alpacas penicillin at 20 000 40 000 IU D kg once or twice daily,
by veterinarians in the UK postal survey.10 However, bac- i.m., for a mean duration of 12.9 ą 7.2 days.15
terial infections were documented and D or diagnosed (by We diagnosed a tooth root abscess in a 4-year-old
cytological examination and response to antibacterial female alpaca with an abscess below the left eye
therapy) in 22% of the alpacas in our retrospective study. (Table 1, case 18). The animal also had symmetrical,
In general, there are no systemic antibiotics approved 3 4 mm diameter, punched-out ulcers, crusts, scaling
for use in alpacas. Off-label antibiotics that are commonly and hair loss that followed blood vessels at the pinnal
useful for treating skin diseases in alpacas include the fol- margins as well as linear, healing areas of alopecia, and
lowing:1 (i) procaine penicillin at 20 000 40 000 IU D kg, scaling on the convex surface of the pinnal mid-line. The
twice daily, subcutaneously (s.c.) or intramuscularly (i.m.); pinnal lesions had appeared a few weeks after the
(ii) ceftiofur at 2.2 mg D kg, twice daily, s.c., i.m. or intra- abscess had been noted and were neither pruritic nor
venously (i.v.); (iii) oxytetracycline at 20 mg D kg every painful. Biopsies were not performed, and a presumptive
3 days, s.c. or i.m.; or (iv) enrofloxacin at 10 mg D kg, once diagnosis of pinnal vasculitis, possibly secondary to the
daily, per os (p.o.). The subcutaneous space of alpaca tooth root abscess, was made. The animal was treated
skin is inelastic and small, and no more than 10 mL of with maxillary tooth extraction and ceftiofur, and both the
solution should be injected into a single site; the fold abscess and the presumed pinnal vasculitis resolved.
of skin in the axilla or just cranial to the shoulder is
recommended.2 Dermatophilosis
Anecdotal reports indicate that dermatophilosis occurs in
Corynebacterium pseudotuberculosis infection alpacas.2,4,7,8,10 The disease is said to occur most fre-
Corynebacterium pseudotuberculosis infections appear quently in hot, humid regions of the USA, and frequently
to be common in alpacas.2,11 13 Infection may occur by to present as thick crusts on the pinnae.8 Although we
wound contamination or by consuming infected milk.13 see dermatophilosis in horses, cattle and goats in our
Affected animals range from 22 days to 14 months of practice area, we documented no cases in our retrospec-
age. tive study.
Lesions are solitary or multiple subcutaneous nodules
or abscesses. The head, submandibular and ventral cervi- Bacterial folliculitis
cal regions are most commonly affected. Early lesions are Anecdotal reports indicate that bacterial (staphylococcal)
characterized by pyogranulomatous inflammation with folliculitis occurs in alpacas.2,4,8 We diagnosed bacterial
central caseous necrosis (nodule), while older lesions are folliculitis in 13 alpacas in our retrospective study. In ten
characterized by liquefactive necrosis and peripheral fibro- animals, the folliculitis was idiopathic (cases 9 15 and
sis (abscess).13 Diagnosis is confirmed by culture. 45 47), and in three animals it was associated with pre-
Traditional treatment consists of surgical drainage, sumed insect-bite hypersensitivity (cases 29 and 31) or
flushing and systemic antibiotics.11 However, en bloc contact dermatitis (case 44). Lesions consisted of ery-
excision may be the best way to control local infections, thematous papules, pustules, brown-to-yellow crusts,
as abscesses may recur following traditional treatment.11 epidermal collarettes, and annular areas of alopecia and
Furthermore, spontaneous or surgical drainage potentially scaling (Figure 1). The muzzle, back, ventrum and distal
contaminates the environment.11 Corynebacterium pseu- hindlegs were most commonly affected. Pruritus was
dotuberculosis is considered a zoonotic risk; however, only reported in the three alpacas with concurrent pre-
C. pseudotuberculosis infection was not documented in sumed insect-bite hypersensitivity or contact dermatitis.
this retrospective study. Skin scrapings and trichography were negative for para-
sites and fungi. Cytological examination revealed degen-
Tooth root abscesses erate and nondegenerate neutrophils and phagocytosed
Tooth root abscesses present as firm mandibular swell- cocci. Cultures were not performed. Histological exami-
ings, with or without draining tracts.14,15 Mandibular teeth nation of biopsy specimens confirmed suppurative lumi-
are more commonly involved than maxillary teeth, and nal folliculitis in six animals (cases 11 13 and 45 47;
molars and premolars are more commonly affected than Figure 2). Eosinophils were rarely seen. Follow-up infor-
incisors. The median age at presentation is 5 years, mation was available for eight treated animals, as follows:
which correlates with the eruption of permanent teeth.15 two (cases 9 and 13) were cured with the topical applica-
It has been postulated that infection occurs when the tion of povidone-iodine; and six (cases 11, 12, 29 and
� 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16. 3
Scott et al.
Table 1. Data on 68 alpacas with dermatological disease (Cornell University 1997 2006)*
Follow-up
Case Age (years) Sex Diagnosis(es) period (months)
1 1 F Bite wounds 24
2 1 F Bite wounds Died
3 1 F Bite wounds 12
4 8 M Bite wounds Died
5 0.8 F Bite wounds Died
6 1.5 F Bite wounds Died
7 1 F Bite wounds 12
8 0.7 F Bite wounds Died
9 Adult F Bacterial folliculitis 12
10 Adult F Bacterial folliculitis 0
11 7 F Bacterial folliculitis 12
12 1.5 M Bacterial folliculitis 20
13 Adult F Bacterial folliculitis 6
14 3 F Bacterial folliculitis 0
15 3 F Bacterial folliculitis 0
16 3 F Bacterial intertrigo 24
17 7 F Bacterial intertrigo 0
18 4 F Tooth root abscess, pinnal vasculitis 12
19 4 F Zinc-responsive dermatitis 12
20 3 F Zinc-responsive dermatitis 12
21 3 F Zinc-responsive dermatitis 6
22 4 F Zinc-responsive dermatitis 12
23 1.5 M Zinc-responsive dermatitis 12
24 0.8 F Chorioptic mange Euthanized
25 5.5 F Chorioptic mange 0
26 5 M Chorioptic mange 18
27 7 F Psoroptic mange 12
28 0.8 M Psoroptic mange 12
29 11 F Insect-bite hypersensitivity , bacterial folliculitis 24
30 1 M Insect-bite hypersensitivity 24
31 1 M Insect-bite hypersensitivity , bacterial folliculitis 0
32 8 F Insect-bite hypersensitivity 12
33 0.8 F Contagious viral pustular dermatitis Died
34 0.1 F Anagen defluxion 6
35 Adult F Telogen defluxion 0
36 0.3 F Ichthyosis Euthanized
37 1 M Sterile eosinophilic folliculitis and furunculosis 24
38 5 M Adverse cutaneous drug reaction 12
39 8 F Hair follicle hamartomas 12
40 5 F Hair follicle hamartomas 12
41 6 F Viral papillomas 6
42 4 M Viral fibropapillomas 12
43 Adult F Dermatophytosis 9
44 Adult M Contact dermatitis , bacterial folliculitis 18
45 2 F Bacterial folliculitis 12
46 3 M Bacterial folliculitis, abscess 6
47 0.7 M Bacterial folliculitis, pyogranuloma 12
48 2 F Psoroptic mange 6
49 Adult F Chorioptic mange 24
50 2 F Idiopathic urticaria 72
51 5 F Insect-bite hypersensitivity Killed
52 4 F Ichthyosis 24
53 1.5 M Ichthyosis Euthanized
54 3 F Hybrid follicular cysts 6
55 2 M Hybrid follicular cysts 24
56 Adult M Hybrid follicular cysts 24
57 11 F Fibroma 24
58 Adult F Fibroma 36
59 6 F Melanocytoma 48
60 14 M Trichoepithelioma 24
61 1.5 F Lymphoma Euthanized
62 0.1 F Bilateral aural haematomas and chondritis 36
63 0.1 M Bilateral aural haematomas and chondritis 24
64 0.3 F Bilateral aural haematomas and chondritis 36
65 0.2 F Bilateral aural haematomas and chondritis 36
66 0.3 M Bilateral aural haematomas and chondritis 24
67 0.1 F Bilateral aural haematomas and chondritis 24
68 3 M Collagenous hamartomas 12
*Cases 1 40 were patients at the Cornell University Hospital for Animals. Cases 41 68 had skin-biopsy specimens submitted to the Animal Health Diagnos-
tic Center at Cornell University.

Presumptive diagnosis.
F, female; M, male.
4 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.
Skin diseases in the alpaca
Figure 1. Ventral abdominal area of an alpaca with bacterial folliculi-
tis. Note erythematous papules, pustules and crusts.
Figure 3. Photomicrograph of skin-biopsy specimen from an alpaca
with dermatophytosis. Dermatophyte hyphae are present in the kera-
tin surrounding hair shafts (arrow). Periodic acid Schiff; scale
bar = 50 lm.
Mycobacterium ulcerans was identified (by culture and
polymerase chain reaction) in a large ulcer on a leg of an
alpaca in southeastern Australia.16 No details were given.
Cutaneous infection with Actinobacillus lignieresi was
reported in an alpaca in the UK.2 No details were given.
Fungal diseases
Anecdotal reports indicate that dermatophytosis occurs in
alpacas.2,4,7 10 Fungal infection accounted for 3% of the
dermatological diagnoses made by attending veterinari-
ans in the UK postal survey.10 We documented only one
Figure 2. Photomicrograph of skin-biopsy specimen from an alpaca
case of dermatophytosis in our retrospective study (1.5%
with bacterial folliculitis. Note luminal suppurative folliculitis (arrow).
of the cases). An adult female alpaca (case 43) developed
Haematoxylin and eosin; scale bar = 200 lm.
an alopecic, crusted, hyperkeratotic area on the upper lip.
Histological examination revealed a suppurative luminal
45 47) were cured after the systemic administration of folliculitis, with fungal hyphae and arthroconidia within fol-
ceftiofur for 10 21 days. licular keratin, but not within hair shafts (Figure 3). Fungal
culture was not performed. The condition was treated
Intertrigo with topical clotrimazole, twice daily, and resolved in
Intertrigo (skin-fold dermatitis) is a frictional dermatitis 2 weeks.
that occurs where two skin surfaces are intimately
apposed. We diagnosed intertrigo with secondary bacte- Viral diseases
rial infection in two alpacas (cases 16 and 17). In both Contagious viral pustular dermatitis ( orf or  contagious
cases, cytological examination revealed pus and phagocy- ecthmya ) is a parapoxvirus infection that has been
tosed cocci. The intertrigo and secondary infection were reported in alpacas.2,4,7 10,17 Affected animals are typi-
perivulvar in case 17. In case 16, a hernia developed cally 2 4 months old. Thick crusts are present on the lips
in the left ventral flank area post-Caesarean section. The and nostrils. Infected nursing cria may transmit the
intertrigo and bacterial infection developed in the apposed disease to the teats of the dam. The disease is a zoonotic
skin of the left inguinal region and medial aspect of the risk. The condition is typically self-limiting, although one
left thigh. The animal was cured after surgical repair of author mentions that a chronic form lasting  months can
the hernia and a course of systemic ceftiofur. be seen.8 Diagnosis is confirmed by viral isolation and
viral antigen detection techniques.
Miscellaneous bacterial infections We diagnosed presumptive contagious viral pustular
Bacterial pseudomycetoma ( botryomycosis ) was dermatitis in a 9-month-old alpaca that died shortly after
reported in one alpaca in the USA.8 The animal had multi- being admitted to the CUHA (case 33). Thick crusts, ooz-
ple abscesses and granulomas, 0.5 4 cm diameter, on ing and ulceration were present on the nostrils, upper and
the medial thigh. Diagnosis was confirmed by histological lower lips. Necropsy examination revealed pericardial
examination and culture (Staphylococcus aureus). Sur- effusion and hepatic lipidosis. Histological examination of
gery followed by 4 weeks of broad-spectrum antibiotic skin specimens revealed ballooning degeneration of
therapy was reported to be successful. Further details epidermal keratinocytes and eosinophilic intracytoplasmic
were not given. inclusion bodies consistent with parapox infection.
� 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16. 5
Scott et al.
Specific viral isolation and identification techniques were ivermectin for routine deworming.4 6 However, there
not performed. have been reports of treatment failures with ivermec-
tin,2,29,30 as well as doramectin,29,30 eprinomectin,30
Ectoparasitic diseases amitraz29 and diazinon.29 We diagnosed no cases of sarc-
By far the most commonly reported skin diseases of optic mange in our retrospective study.
alpacas are caused by ectoparasites, especially mange
mites and lice.2,4,8,10 Ectoparasitism accounted for 19% Psoroptic mange
of the dermatological diagnoses rendered by attending Psoroptic mange is caused by a psoroptic mite previously
veterinarians in the UK postal survey.10 Ectoparasitism referred to as Psoroptes communis var. auchinae, P. au-
accounted for 10% of the cases in our retrospective chinae, P. cuniculi and P. ovis.31,32 In fact, the species of
study. Alpacas develop sarcoptic mange, psoroptic Psoroptes mite that infests alpacas has not been officially
mange and chorioptic mange; and all three mites have named, and recent authors use the name Psoroptes sp.2
been reported to simultaneously infect the same Alpacas with psoroptic mange most commonly present
animals.18 with dermatitis on the head, face and pinnae.2,4,8,10,18,31 33
In general, there are no ectoparasiticides approved for In some individuals, only the ear canals are affected, and
use in alpacas. In addition, pharmacokinetic studies of the animals present for ear twitching, head shaking, large
macrocyclic lactones (avermectins) in New World came- dry flakes in the ear canals and occasional purulent dis-
lids are limited, and most have been conducted in charge due to secondary bacterial infection.8,32 Skin
llamas.19 22 These studies suggest that the absorption of lesions include papules, crusts, exudation, alopecia and
these compounds, irrespective of the route of administra- pruritus. A more widespread distribution of lesions may
tion, is somewhat lower than that in cattle and sheep. be seen: shoulders, back, rump, sides and perineum.2,8,32
Thus, higher doses (e.g. 0.4 mg D kg ivermectin, every Psoroptic mange does not constitute a zoonotic risk.
7 days, s.c.) may be necessary in alpacas.2 Sterile Diagnosis is confirmed by finding mites in skin scrap-
abscesses may be seen with the s.c. administration of ings. Ivermectin, as described previously for sarcoptic
ivermectin, and inconspicuous injection sites (such as the mange, is usually effective for treatment.2,4,18,31
axilla) have been recommended.1,2 It is common to inject We diagnosed psoroptic mange (positive skin scrap-
ivermectin s.c. in the neck just cranial to the shoulder ings) in one alpaca (case 48) and suspected it in two others
(much easier to do here; fibre coat makes any resulting (cases 27 and 28). All animals had crusts, scales, alopecia
lumps inconspicuous). and pruritus involving the pinnae and face. Skin scrapings
An additional consideration is that alpaca fibre does not were negative in two cases, but cytological examination
contain lanolin, so that topical applications of insecticides revealed eosinophilic inflammation. Biopsy specimens
and acaricides used on other ruminants may not be as from two animals (cases 27 and 48) revealed superficial
effective in alpacas.2 and deep eosinophilic interstitial dermatitis with marked
parakeratotic hyperkeratosis. Mites were seen in surface
Sarcoptic mange crust in one case (case 48). All three alpacas were cured
Sarcoptic mange is caused by Sarcoptes scabiei var. after a course of s.c. ivermectin injections.
auchinae. It has been reported from many countries in
the world, and is a significant cause of weight loss and Chorioptic mange
decreased fibre production.2,4,8,10,18,23 30 Sarcoptic Chorioptic mange is caused by Chorioptes bovis. It has
mange has been reported to be responsible for up to been reported from many countries in the world, and
95% of the economic losses caused by ectoparasites in appears to be the most common mite infestation of alpa-
alpacas, with up to 40% of alpacas being infested. cas.2,4,18,32,34 40
Alpacas with sarcoptic mange present with alopecia Alpacas with chorioptic mange often initially present
and usually severe pruritus.2,4,8,10,18,30 Early skin lesions with scale, crusts and alopecia on the ventral tail, perineal
consist of erythema, papules and yellow-to-grey crusts. region, ventral abdomen and medial thighs.2,8,32 Lesions
Chronic changes include marked skin thickening, lichenifi- then spread to the axillae, tips and lateral surface of the
cation and hyperpigmentation. The disease often begins pinnae, interdigital spaces and distal limbs up to the fet-
on the ventral abdomen and chest, axillae and groin, with locks. In some outbreaks, lesions are more commonly
gradual extension to the medial thighs, prepuce, peri- seen on the pinnae, face, neck, dorsum and feet.4,37,39,40
neum, legs, interdigital spaces, face and pinnae. Second- In severe cases, erosions, ulcers and lichenification can
ary bacterial infection can complicate the condition.8 be seen. Pruritus is usually absent or mild. Chorioptic
Sarcoptic mange in alpacas is a potential zoonosis.2,4,8 mange does not constitute a zoonotic risk.
Diagnosis of sarcoptic mange is confirmed by finding Diagnosis is confirmed by finding mites in skin scrap-
mites in skin scrapings; however, negative skin scrapings ings. In a study on the prevalence of Chorioptes bovis
do not rule out the disease.2,4 Histopathological findings infestation in alpacas in the UK,39 skin scrapings were
include a superficial eosinophilic interstitial dermatitis, positive in 55% of the clinically normal in-contact animals,
marked parakeratotic hyperkeratosis, and mites in the but positive in only 28% of the animals with skin lesions.
surface keratin and crusts.28 Clinically normal, skin-scrape-positive alpacas tended to
Ivermectin (0.2 0.4 mg D kg, every 7 14 days, s.c., for be younger (<24 months old), whereas alpacas with skin
two to four injections) has been reported to be an effec- lesions tended to be older. It is not clear whether or not
tive treatment.2,4,18,27 It has been suggested that sarcop- all of the alpacas with skin lesions in the UK study had
tic mange is rare in the USA because of the use of chorioptic mange. However, other investigators have also
6 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.
Skin diseases in the alpaca
Figure 5. Photomicrograph of skin-biopsy specimen from an alpaca
with chorioptic mange. Note cross-section of mite (arrow) in surface
keratin. Haematoxylin and eosin; scale bar = 200 lm.
Pediculosis
Pediculosis in alpacas is caused by two species of lice:
the chewing louse Bovicola (Lepikentron) breviceps and
the sucking louse Microthoracius mazzi (praelongiceps).
Louse infestations have been reported from many areas
of the world.2,4,7 9,41 48 Pediculosis has been estimated
to produce annual net profit losses of 5 85%, with
weight loss and fibre damage resulting from disturbed
feeding and sleeping schedules and stress in association
with pruritus.41,42,44
Heavy louse infestations cause alpacas to bite, rub and
Figure 4. Caudal pastern of an alpaca with chorioptic mange. Note
kick their skin, resulting in variable degrees of traumatic
alopecia, scaling and crusts.
alopecia, excoriation and secondary bacterial infec-
tions.2,4,7 9,41,42,44 47 Chewing lice may be more numer-
indicated that heavily infested alpacas can be clinically ous on the rump, dorsal trunk and neck, and sucking lice
normal, and alpacas with extensive lesions can have on the head, neck and shoulder. Heavy infestations with
low numbers of mites.4,36,40 Skin scrapings from the sucking lice may produce anaemia. Diagnosis is made by
axilla and interdigital space are the most commonly posi- parting the fleece in various areas and visualizing lice on
tive.4,39 Histological examination of skin-biopsy speci- the skin surface and D or eggs ( nits ) attached to the fibres
mens is reported to reveal eosinophilic perivascular (often 5 10 mm above skin surface).
dermatitis and eosinophilic epidermal microabscesses Treatment recommendations for pediculosis in alpacas
and pustules.37 are often anecdotal and contradictory. Topical applications
Chorioptic mange in alpacas is a therapeutic challenge. have been reported usually to be ineffective.46 Repeated
Repeated s.c. injections of ivermectin (0.2 0.4 mg D kg) injections of ivermectin or moxidectin have been reported
reduce mite numbers and lesion severity, but do not erad- to be effective,41,44 or effective for sucking lice but not
icate mites and any associated dermatitis.2,18,37,38 Similar for chewing lice.7 A single alpaca was reported to be
results were obtained with repeated topical applications cured with topical applications of cypermethrin
of eprinomectin (0.5 mg D kg).38,40 Anecdotal reports sug- (10 mg D kg), but no follow-up period was stated.45 Eradi-
gest that topical applications of fipronil may be effective.2 cation of B. breviceps from 25 alpacas in Australia was
We diagnosed chorioptic mange in three alpacas (cases achieved with two 8 min shower-dip applications of
24 26) in our retrospective study and suspected it in one spinosad (25 g D L) in combination with a surfactant wet-
other (case 49). All four animals had nonpruritic crusts, ting agent (alcohol alkocylate at 1000 g D L) with a 17-day
scales and alopecia on the tail, perineum, hindlegs and interval.47 If feasible, shearing is a useful prelude to the
hindfeet (Figure 4). Two animals additionally had lesions use of antiparasitic agents. We did not diagnose pediculo-
on the axillae and front feet. One animal also had lesions sis in our retrospective study.
on the pinnae. Skin scrapings were positive, and biopsy
specimens revealed eosinophilic interstitial dermatitis in Miscellaneous ectoparasites
three alpacas (cases 24, 26 and 49). Mites were present Anecdotal reports indicate that alpacas may be infested
in surface crusts in case 24 (Figure 5). One animal (case with fleas; attacked by mosquitoes, black flies, tabanids
24) was euthanized due to endometritis. Two animals and ticks; and suffer from myiasis.7 9 The same reports
(cases 26 and 49) were successfully treated with weekly indicate that Otobius megnini (spinose ear tick) can affect
topical applications of 2% lime sulfur for 6 8 weeks. alpacas in the western USA, causing head shaking and
� 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16. 7
Scott et al.
otorrhoea.7 9 Ivermectin injections (0.2 mg D kg) were
reported to be an effective treatment.
Neoplastic and non-neoplastic tumours
In a retrospective study of 368 alpaca specimens (biopsy
or necropsy) from the northwestern USA, neoplasia was
diagnosed in 18 animals (prevalence of 4.9%).49 Cutane-
ous and mucocutaneous neoplasms accounted for 50%
of the cases. Eight of the nine skin neoplasms were
characterized as fibropapillomas or fibromas. Affected
animals ranged from 4 to 12 years old, and had single or
multiple lesions on the face, nose, lip or distal leg. Poly-
merase chain reaction studies to look for papillomavirus
DNA were not performed. One alpaca in this report had a
solitary fibrosarcoma on the lip.
Mucocutaneous fibropapillomas associated with a
unique camelid papillomavirus were reported in three
alpacas, all of which were 6 years old, from the northeast-
ern USA.50 Lesions manifested as grey, hyperkeratotic,
Figure 6. Photomicrograph of hybrid follicular cyst excised from an
nodular masses on lips or cheeks. Histologically, the
alpaca. Cyst cavity (arrow) contains both lamellar and tricholemmal
masses were similar to equine sarcoids. Polymerase
keratin. Haematoxylin and eosin; scale bar = 1 mm.
chain reaction testing revealed that all lesions were posi-
tive for papillomavirus DNA that had 73% homology with
bovine papillomavirus-1. In two animals, lesions were
surgically excised, with no recurrence after a 9-month
follow-up period.
Multiple trichoepitheliomas were reported in a 13-year-
old male alpaca.51 The lesions were well-circumscribed,
ovoid, 1 4 cm diameter dermal masses distributed over
both sides of the body (especially neck, thorax and rump).
Neoplastic and non-neoplastic tumours accounted for
19% of the cases in our retrospective study (Table 1).
Two animals had multiple presumed viral papillomas D
fibropapillomas (raised, hyperkeratotic, 0.2 2 cm diame-
ter) on the lips (case 41) or on three pasterns (case 42).
Histological findings were typical for papillomavirus infec-
tion (koilocytosis, irregularities in keratohyalin granule
morphology), but no specific tests were performed.
There had been no regression of nonexcised lesions after
Figure 7. Close-up of Figure 6. Tricholemmal differentiation
6 12 months. Two animals (cases 57 and 58) had solitary
(black arrow) and associated tricholemmal keratinization alternates
fibromas (white, alopecic, firm, 2 3 cm diameter)
with epidermal differentiation (red arrow) and associated lamellar
excised from the lower lip with no recurrence after keratinization. Haematoxylin and eosin; scale bar = 200 lm.
24 36 months. A solitary dermal melanocytoma (black,
alopecic, firm, 4 mm diameter) was excised from the
nous hamartomas. The lesions seemed stable over a
right lower eyelid with no recurrence after 48 months
12-month follow-up period. In two animals (cases 39 and
(case 59). A solitary trichoepithelioma (alopecic, firm,
40), a mother and daughter, lesions were first noted at
ulcerated) was excised from the lateral neck region with
about 3 years of age. The lesions were multiple, multifocal
no recurrence after 24 months (case 60). One animal
(especially the trunk), firm, round-to-rectangular, slightly
(case 61) had multiple subcutaneous lymphomas widely
elevated dermal plaques varying from 1 to 10 cm in diam-
distributed over the body. The animal was euthanized,
eter. Fleece loss was minimal, and the skin overlying the
and necropsy was not performed.
lesions was smooth to mildly hyperkeratotic. Lesions
Three animals (cases 54 56) had multiple hybrid follicu-
were neither pruritic nor painful. Histologically, these
lar cysts (Figures 6 and 7; white, smooth, 1 3 cm diame-
lesions were hair follicle hamartomas (Figure 8). Lesions
ter, occasional spontaneous caseous black discharge)
seemed to be stable after a 12-month follow-up period.
widespread over the body, especially the trunk. Cytologi-
cal examination of the caseous discharge revealed
Environmental diseases
corneocytes and numerous melanin granules. Lesions
seemed to be stable during 6- to 24-month follow-up Traumatic wounds
periods. Anecdotal reports indicate that lacerations and puncture
Multiple hamartomas were diagnosed in three animals. wounds are common in alpacas.7,8 Lacerations (especially
In case 68, the lesions (firm, smooth) were present on to the pinnae, neck, caudal pelvic limbs and scrotum) are
eyelid, neck and foot. Histologically, these were collage- often produced by barbed wire fencing or by aggressive
8 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.
Skin diseases in the alpaca
Figure 8. Photomicrograph of hair follicle hamartoma excised
from an alpaca. The middle and deep dermis are filled with hyper-
plastic hair follicles (arrow). Haematoxylin and eosin; scale bar =
1 mm.
males interacting with other males or attacking females.
Dogs (individually or in packs) can inflict horrible wounds
that can be lethal.
We diagnosed dog bite wounds in eight alpacas (cases
1 8). Seven of the eight animals were approximately
1 year old. Bite wounds most commonly involved the
Figure 9. Anagen defluxion in an alpaca cria in association with a
neck and hindlimbs, and cellulitis and subcutaneous
diarrhoeal disorder. Note noninflammatory hair loss on the legs.
emphysema were present in six and four cases, respec-
tively. All animals received aggressive emergency and
supportive care, but five (62%) died.
and most commonly involve the face. Bite wounds and
swelling are present, and concurrent systemic signs
Contact dermatitis
(especially tachypnoea, respiratory distress and hyper-
Anecdotal reports indicate the contact dermatitis can
thermia) may be seen in alpacas.
be seen in alpacas.7,8 Incriminated contactants include
plants, chemicals and povidone-iodine. Anecdotal reports
Miscellaneous diseases
indicate that shearing alpacas with clippers that are too
hot can result in thermal burns, which may result in Noninflammatory alopecia
sloughing of severely damaged skin several weeks later. Shedding in alpacas may be imperceptible or occur as pat-
We made a presumptive diagnosis of contact dermatitis chy alopecia, especially over the neck.7 It is occasionally
and secondary bacterial folliculitis in one alpaca (case 44) mistaken for a sign of disease.
in our retrospective study. The animal had a chronic his- Anecdotal reports indicate that large patches of hair
tory of pruritic dermatitis affecting the entire ventrum. may be lost with no apparent inciting cause.8 Often the
Histological findings included suppurative luminal folliculi- hairs appear broken off, and analogous to  wool break
tis and a superficial perivascular-to-interstitial lymphoplas- (anagen defluxion) in sheep. We diagnosed anagen
macytic dermatitis. Eosinophils were rarely seen. Pruritic defluxion53 in a cria (case 34) that acutely developed mul-
dermatitis continued after the bacterial infection was trea- tiple areas of hair loss over the face, trunk and legs 7 days
ted with ceftiofur. Prednisone (1 mg D kg once daily) was after the onset of a diarrhoeal disorder (Salmonella sp.
administered p.o. for 14 days, the animal s access to the cultured from faeces) and antibiotic therapy (Figure 9).
outdoor environment was restricted, and the pruritic The skin appeared normal, and short, broken-off hairs
dermatitis completely resolved. Provocative exposure could be seen and palpated in the hypotrichotic areas.
was not attempted. No relapse was seen over an 18- Trichographic findings were consistent with anagen
month follow-up period. defluxion. We also diagnosed telogen defluxion53 in an
alpaca (case 35) presented for the acute onset of hair loss
Snake bite over the trunk and face several weeks after a poorly
Rattlesnake envenomation has been reported in the defined illness (Figure 10). The skin appeared normal, and
southwestern USA.52 Most bites occur in the period from hair was totally absent in alopecic areas. Trichographic
spring to summer, especially at night or early morning, findings were consistent with telogen defluxion.
� 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16. 9
Scott et al.
Figure 10. Telogen defluxion in an adult alpaca following a poorly
defined illness. Note noninflammatory hair loss on face.
Immunological diseases
Anecdotal reports indicate that pemphigus-like diseases,
adverse cutaneous drug reactions, cutaneous vasculitis,
and food and environmental allergies may occur in alpa-
Figure 12. Same alpaca as in Figure 11. Note multiple pustules
cas.2,10 We diagnosed presumed pinnal vasculitis associ-
(arrow) on ventral abdomen.
ated with a tooth root abscess in one alpaca (see
discussion of case 18 with tooth root abscess).
became febrile, depressed and inappetent, and skin
We diagnosed a presumed adverse cutaneous drug
lesions appeared on the perineum and ventral abdomen.
reaction in a 5-year-old male alpaca (case 38) with an
When the animal was examined at the CUHA, additional
acute history of skin and systemic disease following an
findings included numerous pustules on the ventral abdo-
injection of ivermectin. The animal first developed
men, prepuce, perineum, and inguinal and axillary areas
 bumps on the pinnae, which rapidly progressed to ulcers
(Figure 12). Skin scrapings and trichography were nega-
and general pinnal swelling (Figure 11). The alpaca
tive. Cytological examination of pus revealed eosinophils
and nondegenerate neutrophils, and no microorganisms.
A pustule was cultured and was negative for bacteria and
fungi. Results of routine haematology and serum bio-
chemistry panel were unremarkable. Histological findings
of multiple skin biopsies were characterized by eosino-
philic and neutrophilic epidermitis and luminal folliculitis
and furunculosis (Figure 13), and special stains for micro-
organisms were negative. The alpaca was treated with
methylprednisolone (1 mg D kg given once daily p.o.) and
Figure 13. Photomicrograph of skin-biopsy specimen from the
Figure 11. Presumed adverse cutaneous drug reaction due to iver- alpaca in Figures 11 and 12. Large pustule (large arrow) is formed by
mectin in an alpaca. Note linear ulcer on convex (dorsal) surface of coalescence of furunculosis of three pilosebaceous units (small
pinna. arrows). Haematoxylin and eosin; scale bar = 1 mm.
10 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.
Skin diseases in the alpaca
Figure 16. Photomicrograph of skin-biopsy specimen from an alpaca
Figure 14. Presumed insect-bite hypersensitivity in an alpaca. Note
with presumed insect-bite hypersensitivity. Note hyperplastic peri-
alopecia, erythema and multiple crusts on face.
vascular dermatitis (black arrow) with compact orthokeratotic hyper-
keratosis (white arrow) consistent with chronic rubbing, scratching
completely recovered. Ivermectin has not been readmin-
and chewing in response to pruritus. Haematoxylin and eosin; scale
istered, and the alpaca remains normal after a 12-month
bar = 200 lm.
follow-up period.
Skin scrapings and trichography were negative in all
Idiopathic urticaria was diagnosed in one alpaca (case
cases. Cytological examination revealed eosinophilic
50) in our retrospective study. The animal had recurring
inflammation in two animals. Two animals (cases 29 and
nonpruritic wheals over the neck and trunk. No triggering
31) had concurrent bacterial folliculitis (see earlier discus-
agents were identified. Histological findings included
sion). Histological findings in biopsy specimens from two
pure superficial perivascular lymphoeosinophilic derma-
alpacas (cases 29 and 51) included eosinophilic interstitial
titis with moderate superficial dermal oedema. After a
dermatitis, eosinophilic epidermal microabscesses, eosin-
several week course of lesions, the condition disappeared
ophilic infiltrative mural and luminal folliculitis, and com-
for a 72-month follow-up period.
pact orthokeratotic hyperkeratosis (Figures 16 and 17).
Presumed insect-bite hypersensitivity (probably associ-
The latter finding is consistent with chronic rubbing,
ated with Culicoides spp. gnats) was diagnosed in five
scratching and chewing in response to pruritus. Three ani-
alpacas (cases 29 32 and 51) in our retrospective study.
mals (cases 29, 30 and 32) improved markedly with pro-
Four animals (cases 29, 31, 32 and 51) had a recurrent or
tective housing (dusk to dawn) and permethrin-containing
seasonal (spring to autumn) pruritic dermatitis for  several
sprays.
years , which spontaneously resolved without treatment
every winter. All five alpacas were the only affected ani-
Congenital diseases
mals in their respective herds. Treatment with ivermectin
Ichthyosis was diagnosed in three alpacas (cases 36, 52
had been ineffective. Lesions had the following character-
and 53). The animals had a generalized keratinization dis-
istics: (i) they were more-or-less symmetrical; (ii) they
order since birth or shortly thereafter. Fine, nonadherent
most commonly affected the pinnae, periocular area,
white scales covered nearly the entire body surface and
bridge of the nose, axillae, groin, ventral mid-line and dis-
were scattered throughout the fleece. In one of the ani-
tal legs; and (iii) they consisted of alopecia, crusts, licheni-
fication and occasionally papules (Figures 14 and 15).
Figure 15. Same alpaca as in Figure 14. Note alopecia, erythema, Figure 17. Close-up of Figure 16. Note perivascular (black arrow
papules and crusts on ventral abdomen, medial thighs (arrows) and indicates segment of blood vessel) accumulation of eosinophils (red
perineum. arrow). Haematoxylin and eosin; scale bar = 50 lm.
� 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16. 11
Scott et al.
mals, multiple areas of erythema were present on the males, and animals with dark fleeces may be more fre-
abdomen. Pruritus was absent, and the animals appeared quently affected.5,8 Typically, only a few individuals in a
to be otherwise healthy. Parents and relatives of these herd are affected.
alpacas were reported to be unaffected. Histological find- In a study conducted on a German farm,54 the zinc sta-
ings in skin-biopsy specimens revealed diffuse orthokera- tus of alpacas was evaluated. The animals were supple-
totic hyperkeratosis (epidermis and hair follicles) and mented with a commercial camelid feed, but their hay
minimal to no inflammation. Eosinophils were not seen. had an inadequate mineral content. Twenty-five per cent
Treatment was not attempted, and two animals were of the animals in the herd had lesions on the bridge of the
euthanized (no necropsy performed). nose and the pinnae. Only females were affected, and all
Bilateral aural haematomas and chondritis occurred in had given birth that year or were pregnant. Animals with
six crias (cases 62 67) on the same farm in our retrospec- nonwhite fleeces were more likely to have skin lesions.
tive study. All cria were affected at birth. There was no There was no influence of sex, fleece colour or breed (suri
history of prior trauma to the pinna. The same sire and versus huacaya) on serum zinc or copper concentrations.
three different dams were involved. The sire had been It was not possible to distinguish affected from nonaffect-
used on other farms and had reportedly produced other ed alpacas based on serum mineral concentrations. The
affected cria. Multiple small, fluid-filled, flat plaques authors of this study made the following suggestions: (i)
occurred on the lateral surface of both pinnae. Signs of that skin lesions are most likely to occur first in breeding
infection (heat, discoloration, wounds and draining tracts) females when the mineral content of the diet is marginal;
were not present. Pruritus and otitis were not present, (ii) that dark fleeces, which contain more zinc and copper
and the crias were otherwise healthy. Skin-biopsy speci- than white fleeces, are likely to exert higher demands on
mens were taken with a 6-mm biopsy punch when the mineral metabolism; and (iii) that serum zinc concentra-
haematomas were drained. Pinnal lesions healed with tions may not reflect total body zinc levels. Histological
scarring and deformation (Figure 18). Histological findings findings are reported to include diffuse orthokeratotic
included variable combinations of dermal oedema and hyperkeratosis (epidermis and hair follicles) and a mild to
haemorrhage, and necrotic cartilage which was dissected moderate perivascular dermatitis containing lympho-
by neutrophils. cytes, macrophages, plasma cells and occasional eosin-
ophils.2 5,8,54
Zinc-responsive dermatitis Diagnosis is based on history, physical examination,
Zinc-responsive dermatitis accounted for 23% of the der- ruling out other differential diagnoses, and response to
matological diagnoses made by attending veterinarians in zinc supplementation. Animals are given 1 2 g ZnSO4 or
the UK postal survey,10 but only 8% of the cases in our 2 4 g zinc methionine, once daily, p.o., with improvement
retrospective study. being seen within 30 90 days.2,4,8,54
There is limited peer-reviewed literature on the subject We diagnosed zinc-responsive dermatitis in five alpa-
of zinc-responsive dermatitis in alpacas.2 5,8 10 Lesions cas (cases 19 23) presenting with chronic histories of
consist of scales and papules and plaques with thick, nonpruritic dermatitis consisting of alopecia, adherent
tightly-adherent crusts, which are most commonly seen scales, hair casts, thick crusts and occasional hyperkera-
in relatively hairless areas such as the perineum, ventral tosis. Lesions most commonly occurred on the face
abdomen, groin, medial thighs, axillae and medial fore- (muzzle, periocular region), pinnae, neck, ventral abdo-
legs. The bridge of the nose, muzzle and periocular region men, medial thighs and medial forelegs (Figure 19). The
may also be affected. Pruritus is absent or mild. It has feet and distal legs were less commonly affected. The
been suggested that young animals (1 2 years old), animals were on good diets with no mineral supplements
Figure 18. Bilateral aural haematomas and chondritis in a cria. Note Figure 19. Zinc-responsive dermatitis in an alpaca. Thick scale and
scarring and disfigurement of both pinnae. crusts on top of head and dorsal neck.
12 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.
Skin diseases in the alpaca
Figure 21. Presumed insect-bite reaction in an alpaca. Periocular
alopecia, erythema, oedema, pustules and crusts.
Figure 20. Photomicrograph of skin-biopsy specimen from an alpaca
with zinc-responsive dermatitis. Note papillated epidermal hyperpla- The dermatosis usually begins at 6 24 months of age.
sia, papillomatosis (arrows) and orthokeratotic hyperkeratosis. Hae- The nasal and periocular areas become covered with thick
matoxylin and eosin; scale bar = 1 mm.
crusts that occasionally obstruct the nostrils. Lesions
may occasionally occur on the bridge of the nose and peri-
and were generally the only individual in the herd ocular region. Pruritus is usually absent or mild.
affected. Case 19 was one of a herd of 52 alpacas, two Histological findings are reported to include various
others of which had  a similar skin problem . Skin biopsies combinations of epidermal oedema, hyperplasia and
were performed in three animals (cases 19, 20 and 22) necrosis; palisaded crusts (orthokeratotic D parakeratotic
and revealed lymphoeosinophilic superficial perivascular hyperkeratosis and pus); and a mixed perivascular derma-
dermatitis with papillated epidermal hyperplasia, papillo- titis.2 5,8
matosis, and predominantly lamellar orthokeratotic hyper- Treatment observations are consistent with the
keratosis of the epidermis and hair follicle infundibula aforementioned idea that many different conditions are
(Figure 20). Occasional papillae were  capped with being called  munge . Cases are reported to respond to
parakeratotic hyperkeratosis. The skin lesions in all five topical and D or systemic antibiotics, topical and D or sys-
alpacas were reported to have resolved with zinc methio- temic glucocorticoids, oral zinc, or to regress sponta-
nine (2 g D day p.o.). Zinc supplementation was continued, neously.2 5,8 We presently believe that idiopathic
and all five alpacas were in remission following periods of nasal D perioral hyperkeratotic dermatosis is a cutaneous
6 12 months. reaction pattern of alpacas possibly provoked by disor-
ders such as bacterial folliculitis, dermatophilosis, dermat-
Focal sterile eosinophilic and neutrophilic folliculitis and ophytosis, contagious viral pustular dermatitis, chorioptic
furunculosis mange, fly bites, viral papillomas D fibropapillomas, contact
A 1-year-old male alpaca (case 37) presented to the CUHA dermatitis and zinc-responsive dermatitis. The authors
with a 1-month history of dermatitis and pruritus around are not aware of any laboratory tests or therapeutic
the right eye. The other animals in the herd were unaf- interventions that allow one to diagnose  munge . Such a
fected. Previous treatment with topical miconazole and multifactorial aetiology could explain the anecdotal suc-
oral enrofloxacin was unsuccessful. The right periocular cesses of popular topical concoctions such as  witches
area was alopecic, erythematous and oedematous with a brew , which contains gentamicin, ivermectin, dimethyl
few pustules and crusts (Figure 21). Skin scrapings and sulfoxide and mineral oil.57
trichography were negative. Cytological examination
revealed eosinophilic inflammation. Histological findings
Discussion
included eosinophilic folliculitis and furunculosis, and spe-
cial stains were negative for microorganisms. Prednisone The popularity and numbers of alpacas have increased in
administered p.o. (1 mg D kg once daily for 2 weeks) was many parts of the world.1 4,10,40 This naturally has led to
curative. This condition is similar to the sterile eosinophilic increasing demands for veterinary care. The number of
folliculitis and furunculosis that occurs in dogs55 and alpaca patients at our university practice increased
horses,56 presumably associated with insect envenoma- approximately 13-fold over a 10-year period. During this
tion. period of time, dermatological diseases were docu-
mented in 5.6% of the alpacas, which is similar to previ-
Idiopathic nasal D perioral hyperkeratotic dermatosis ously reported data on our equine patients (4.1% of all
Idiopathic nasal D perioral hyperkeratotic dermatosis ( mun- horses over a 21 year period).58 Skin-biopsy specimens
ge ) is anecdotally reported to occur in alpacas.2 5,7,8 This accounted for 24.4% of all alpaca biopsy specimens
condition is very poorly understood and may, in fact, be received over the 10 year period, which is again similar to
nothing more than a reaction pattern in the skin caused previously reported data on our equine population (23.4%
by many different factors. of all biopsy specimens).58
� 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16. 13
Scott et al.
To our knowledge, this literature review and retrospec- presumed contact dermatitis, ichthyosis and aural
tive case study is the first one entirely devoted to alpacas. haematomas with chondritis.
While some of our experiences are similar to those In conclusion, skin disease is commonly seen in alpa-
reported in peer-reviewed and anecdotal literature, there cas, and the possible causes are many. We hope this
were some notable differences. For instance, while bac- article will encourage practitioners and specialists to
terial and neoplastic dermatoses accounted for only 5% investigate alpaca dermatoses in greater depth and with
and 0%, respectively, of the conditions diagnosed in a UK enthusiasm and to report their findings. There is much to
postal survey,10 these two categories accounted for 22% be learned.
and 19%, respectively, of the dermatological diagnoses
in our retrospective study conducted in the northeastern
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R�sum� Cette �tude r�trospective d�crit 68 cas de dermatose d alpagas diagnostiqu�s entre 1997 et
2006 ą l Universit� de Cornell. Au cours de cette p�riode, 40 des 715 (5.6%) alpagas vus en consultation ą
l h�pital universitaire pr�sentaient des l�sions dermatologiques. De plus, les biopsies cutan�es repr�senta-
ient 86 des 353 (24.4%) biopsies d alpaga soumises au laboratoire de diagnostic. Sur ces 86 �chantillons,
28 ont pu ętre suivis. Les maladies les plus fr�quentes regroupaient : infections bact�riennes (22%); n�o-
plasmes, kystes et hamartomes (19%); d�sordres immunologiques pr�sum�s (12%); et ectoparasitisme
(10%). Les atteintes d�crites pour la premiŁre fois comprenaient intertrigo, hamartomes collag�nique et
folliculaire, lymphome, kystes folliculaires hybrides, m�lanocytomes, effluvium anagŁne, effluvium t�lo-
gŁne, hypersensibilit� aux piq�res d insectes suppos�e, ichtyose et probablement chondrite et h�matome
auriculaire bilat�raux. Les r�sultats de cette �tude r�trospective sont compar�s et mis en relief avec les
r�sultats d une revue de la litt�rature.
Resumen Este estudio retrospectivo describe 68 alpacas con enfermedades de la piel investigadas des-
de 1997 hasta el ańo 2006 en la Universidad de Cornell. Durante este periodo 40 de 715 alpacas (5,6%)
que llegaron al hospital universitario ten�an enfermedades de la piel. Adem�s biopsias de piel representaron
86 de 353 (24,4%) de las biopsias de alpacas remitidas al laboratorio de diagnostico y de esos 86 especim-
enes seguimiento solo fue obtenido para 28 casos. Las enfermedades mas comunes fueron: infecciones
bacterianas (22%); neoplasias, quistes y hamartomas (19%); presuntos desordenes inmunológicos (12%);
y ectoparasitismo (10%). Las condiciones descritas por primera vez incluyeron intertrigo, hamartomas col-
�genos y de fol�culos pilosos, linfoma, quistes foliculares h�bridos, melanocitoma, defluxión anag�nica, def-
luxión telog�nica, presunta hipersensibilidad a picadura de insecto, ictiosis, y posibles hematomas aurales
bilaterales y condritis. Los resultados de este estudio retrospectivo se comparan y contrastan con los re-
sultados de una revisión bibliogr�fica.
Zusammenfassung Diese retrospektive Studie beschreibt 68 Alpakas mit einer Hauterkrankung, die
zwischen 1997 und 2006 an der Cornell Universit�t untersucht wurden. W�hrend dieser Zeit hatten 40 von
715 (5,6%) Alpakas, die an der Universit�tsklinik vorgestellt wurden, dermatologische Erkrankungen.
Zus�tzlich standen 86 von 353 (24,4%) der Alpaka Biopsien, die an das diagnostische Labor gesendet
wurden, zur Verf�gung und von diesen 86 Proben gab es in 28 F�llen einen Follow-Up. Die h�ufigsten Kran-
kheiten waren: bakterielle Infektionen (22%); Neoplasmen, Zysten und Hamartome (19%); vermeintliche
immunologische Erkrankungen (12%); und Ektoparasiten (10%). Ver�nderungen, die zum ersten Mal besch-
rieben wurden, waren: Intertrigo, Kollagen- und Haarfollikelhamartome, Lymphome, Hybrid-Follikelzysten,
Melanozytome, anagene Defluxion, telogene Defluxion, vermeintliche Insektenstich-Hypersensibilit�t,
Ichthyose und m�gliche heredit�re bilaterale Ohr-H�matome und Chondritis. Die Ergebnisse dieser retro-
spektiven Studie werden verglichen und den Ergebnissen der Literatur-Review gegen�bergestellt.
16 � 2010 The Authors. Journal compilation � 2010 ESVD and ACVD, Veterinary Dermatology, 22, 2 16.