A dog presents with a pruritic skin lesion and is suspected to have acral lick dermatitis. What is the most likely underlying cause?

Acral lick dermatitis, often referred to as lick granuloma, is a condition in which a dog excessively licks a specific area of its skin, leading to irritation, inflammation, and subsequent lesion formation. The underlying cause of this behavior is frequently related to an underlying dermatological or behavioral issue that creates discomfort.

Atopy, an allergic reaction to environmental allergens such as pollen, dust mites, or mold, is the most common underlying cause of acral lick dermatitis. Dogs suffering from atopic dermatitis often experience intense itching and irritation, prompting them to lick affected areas in an attempt to relieve the discomfort. This self-trauma can lead to the development of acral lick dermatitis as the dog continually licks the area, perpetuating the cycle of itching and irritation.

The other options can contribute to skin lesions in dogs, but they are less commonly associated with acral lick dermatitis. Dermatophytosis, a fungal infection, can cause itching but typically affects a broader area rather than being localized to a specific lick site. Hyperadrenocorticism, or Cushing's disease, can alter skin health and integrity but more commonly results in thinning of the skin rather than the local irritation seen in acral lick dermatitis. Pemphigus foliaceus