02374nas a2200253   4500000000100000008004100001260001300042653001400055653002200069653001900091653000900110653001400119100001200133700001200145700001300157700001300170700001400183700001400197245009900211300001200310490000700322520177700329022001402106       2013                            d  c2013 Feb10aTreatment10aLeproid granuloma10aFeline leprosy10aDogs10adiagnosis1 aMalik R1 aSmits B1 aReppas G1 aLaprie C1 aO'Brien C1 aFyfe JA M00aUlcerated and nonulcerated nontuberculous cutaneous mycobacterial granulomas in cats and dogs.  a146-e330 v243 aBackground -  Mycobacterial granulomas of the skin and subcutis can be caused by one of a number of pathogens. This review concentrates on noncultivable species that cause diseases characterized by focal granuloma(s), namely leproid granuloma (in dogs) and feline leprosy (in cats). Clinically indistinguishable lesions can be caused by tuberculous organisms (Mycobacterium bovis and Mycobacterium microti) and members of the Mycobacterium avium complex. Rapidly growing mycobacterial species that cause infection of the subcutaneous panniculus associated with draining tracts are not discussed. Disease caused by Mycobacterium ulcerans is an important emerging differential diagnosis for ulcerated cutaneous nodules in certain localized regions. Clinical lesions -  Lesions comprise one or multiple nodules in the skin/subcutis. These are generally firm and well circumscribed, and typically become denuded of hair. They may or may not ulcerate, depending on the virulence of the causal organisms and the immune response of the host. Diagnosis -  The most inexpensive, noninvasive means of diagnosis is by submission of methanol-fixed, Romanowsky-stained smears to a Mycobacterium Reference Laboratory after detecting negatively stained or acid-fast bacilli on cytological smears. Scrapings of material from slides usually provide sufficient mycobacterial DNA to enable identification of the causal organism using sequence analysis of amplicons after PCR using specific mycobacterial primers. Therapy -  Therapy relies upon a combination of marginal resection of easily accessible lesions and treatment using two or three drugs effective against slowly growing mycobacteria, choosing amongst rifampicin, clarithromycin, clofazimine and pradofloxacin/moxifloxacin.  a1365-3164