A 9-year-old Tennessee Walking Horse gelding was presented for diagnosis of the cause of extensive alopecia. Complete hair loss was noted over the head, neck, shoulder, thigh, and proximal limbs, but the trunk, distal limbs, pelvic area, mane, and tail were unaffected. The alopecic areas were visually noninflammatory with no exudate or crust except on the shoulder and along the back, where multifocal patchy areas of alopecia with scales and crust were evident. The horse was slightly pruritic. Microscopically, the hair bulbs, inner and outer root sheaths of inferior segments, and perifollicular regions were infiltrated by small to moderate numbers of small lymphocytes. Similar inflammation was occasionally evident in isthmus follicular walls as well as some apocrine glands. No sebaceous glands were affected. Immunohistochemistry confirmed that the small lymphocytes were CD3 þ T lymphocytes. The epidermis from the skin with scale and crusts along the horse's back exhibited mild to moderate hyperplasia, mild lymphocytic exocytosis, mild eosinophilic dermatitis, and diffuse parakeratosis with numerous budding yeasts, consistent with Malassezia spp. The final disease diagnosis was made as alopecia areata with Malassezia dermatitis. Alopecia areata could be a contributing underlying factor for Malassezia dermatitis.
Keywords alopecia areata, Malassezia dermatitis, immunohistochemistry, horseA 9-year-old Tennessee Walking Horse gelding was presented to the Veterinary Medical Teaching Hospital, College of Veterinary Medicine, University of Missouri, with extensive alopecia. Bilaterally symmetrical complete hair loss was noted over the head, neck, shoulder, thigh, and proximal limbs, but the trunk, distal limbs, pelvic area, mane, and tail were unaffected (Fig. 1). The alopecic areas were clinically noninflammatory with no exudate or crust except on the shoulder and along the back, especially on the right side, which were multifocally covered with scales and crust. Both pigmented and nonpigmented skin was affected to a similar extent. At the periphery of areas of alopecia, hairs were loose and easily epilated. The horse was slightly pruritic. According to the owner, the alopecia had involved only the head and neck throughout the antecedent 1.5 years, slowly progressed, and then suddenly spread to affect more extensive areas of the body during the 1 to 2 weeks prior to admission. The referring veterinarian had submitted blood for determination of iodothyronine concentrations when alopecia had first been evident 14 months earlier, at which time the circulating thyroxine concentration was very low (T4: <0.05 ug/dL [reference range: 0.5-4.0 ug/dL]; T3: 41.1 ng/dL [reference range: 30-115 ng/dL]). At that time, the gelding's physical appearance was also characterized by marked thickening of the crest of the neck. The veterinarian had addressed suspected hypothyroidism by treating the gelding using an orally administered thyroxine supplement (Thyro-L) for several weeks. At the Veterinary Medical Teaching Hospital, the ...