Oral vitamin A as an adjunct treatment for canine sebaceous adenitis.

Medical records of dogs with sebaceous adenitis diagnosed by histopathology over an 18-year period were reviewed. From a total of 40 cases, 24 were treated with oral vitamin A. Dogs ranged from 9 months to 12 years of age at the time of disease onset. Purebred as well as mixed-breed dogs were affected. Akitas represented approximately one-third of the affected population. No sex predilections were observed. Vitamin A was administered for a minimum of 1 month. Doses varied from 380 to 2667 IU/kg/day, with a mean of 1037 IU/kg/day. Two dogs received oral vitamin A exclusively. Concurrent treatments included systemic antibiotics, systemic antifungal medications, fatty acid supplementation and various topical treatments. Of 24 dogs treated with vitamin A, three were lost to follow-up. Twelve owners were satisfied with the overall appearance of their dogs, reporting ≥25% improvement in clinical signs, including level of pruritus, amount of scale, alopecia and overall coat quality, compared with pretreatment appearance. Three owners observed adequate initial improvement, with regression to pretreatment state within 6 months of starting treatment. Two owners reported 25-50% improvement in clinical signs while on oral vitamin A supplementation; however, changes were attributed to concurrent topical treatment. Six owners reported no improvement and discontinued oral administration of vitamin A within 7 months. No correlations could be made between vitamin A dosage and response to treatment; prognoses could not be made based on clinical and histopathological findings.

Photodynamic therapy with topical aminolevulinic acid and pulsed dye laser irradiation for sebaceous hyperplasia.

Successful and long-standing eradication of sebaceous hyperplasia has remained difficult due to the propensity of these lesions to be extensive. Current treatments include excision, electrodesiccation, laser vaporization, and oral isotretinoin, each often associated with unacceptable side effects or lesional recurrence. The purpose of this study was to evaluate the safety and effectiveness of laser-assisted photodynamic therapy using topical 5-aminolevulinic acid (5-ALA) and 595 nm pulsed dye laser (PDL) irradiation for the treatment of sebaceous hyperplasia. Ten patients with sebaceous hyperplasia received 1 or 2 treatments at 6 week intervals with topical 20% 5-ALA followed 1 hour later by 595 nm PDL irradiation. Matched lesions served as controls and were either treated with PDL alone or were left untreated. Patients were evaluated at regular intervals for 3 months. Results demonstrated that combination topical 5-ALA and PDL treatment effected better clinical results than PDL treatment alone. No changes were observed in untreated control lesions. Side effects were mild and limited to transient erythema, edema, and focal crusting. It is the conclusion of the authors that laser-assisted photodynamic therapy with topical 5-ALA and PDL irradiation can achieve safe and effective improvement of sebaceous hyperplasia. Further study is warranted to determine the longevity of the clinical results observed.