Equine pastern dermatitis: a narrative review on clinical presentation, diagnosis, risk factors, prevention, and therapeutic approaches.
Abstract: 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.
Publication Date: 2023-03-17 PubMed ID: 36917616DOI: 10.2460/javma.22.12.0569Google Scholar: Lookup
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Summary
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Equine Pastern Dermatitis (EPD) is a common but often debilitating skin condition found on a horse’s lower leg area. This review provides an overview of the known clinical presentation, risk factors, prevention and treatment methods of EPD.
Clinical Presentation
- EPD is a cutaneous reaction that typically occurs in the palmar/plantar area of a horse’s pastern, essentially a skin disorder at the lower portion of a horse’s legs.
- This review examines the various forms of EPD and discusses clinical score evaluation methods and how to differentiate the disease from other similar conditions.
Risk Factors
- EPD’s occurrence is associated with several intrinsic and extrinsic risk factors with the majority of studies focused on these aspects.
- Data suggests that age, breed, and breed-related characteristics such as having feathers and a large cannon circumference (the cylindrical part of the lower leg) can impact both the prevalence and the severity of EPD.
- Limbs that are unpigmented or are hind limbs are known to be affected more often.
- While genetic effects are notable in draft breeds, their complexity is yet to be understood. Commercial genetic tests for these do not yet exist.
- The relationship between EPD and rainfall or humidity is inconclusive.
- Studies consistently report associations of EPD with Chorioptes infestation and bacterial microbiome imbalances, but not fungal infections. However, it is yet to be confirmed if specific infectious agents are the direct cause.
Therapeutic Approaches and Prevention
- Regarding treatment, the research examined the effects of antibacterial agents (Kunzea oil, phytosphingosines, triclosan), fatty acids, aromatic oils and humectants, and specific approaches to treat Chorioptes infestation in EPD-affected horses.
- Current treatment methods, however, remain largely empirical due to the complexity of this multifactorial syndrome. That being said, understanding the investigated risk factors can aid in the development of better diagnostics and treatments.
- According to the study, improving horse owner awareness of EPD may be a crucial step in safeguarding the welfare of affected horses.
Cite This Article
APA
Gerber V, Kaiser-Thom S, Oesch S.
(2023).
Equine pastern dermatitis: a narrative review on clinical presentation, diagnosis, risk factors, prevention, and therapeutic approaches.
J Am Vet Med Assoc, 261(S1), S58-S65.
https://doi.org/10.2460/javma.22.12.0569 Publication
Researcher Affiliations
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland.
- 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.
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland.
MeSH Terms
- Animals
- Dermatitis / veterinary
- Extremities
- Horse Diseases / diagnosis
- Horses
- Risk Factors
- Skin
Citations
This article has been cited 4 times.- Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
- Carbonell JD, Fernández N, Escobar MJ, Álvarez MT, Sánchez L, Hernández A, Meana A. Comparative Efficacy of Topical Pyrethroids and Benzoyl Peroxide for Treating Chorioptic Mange in Spanish-Breton Horses. J Parasitol Res 2025;2025:8948099.
- Matinpour M, Zettner N, Neumann K, Bäumer L, Burkovski A. Analysis of the Culturable Skin Microbiome of Horses from Southern Germany. Microorganisms 2025 Mar 8;13(3).
- Styková E, Valocký I, Kačírová J, Fecskeová LK. Microbiological effect of topically applied Weissella cibaria on equine pastern dermatitis. Front Vet Sci 2024;11:1493756.
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