Veterinary Dermatology 2006, 17, 81 84

Blackwell Publishing Ltd

Case report

Dermatitis in a dog induced by Straelensia cynotis: a case report

and review of the literature
FERNANDA SEIXAS*, PAULO J. TRAVASSOS, MARIA L. PINTO*, JOO CORREIA
and MARIA A. PIRES*
*Laboratrio de Histologia e Anatomia Patolgica, Clnicas Veterinrias, Universidade de Trs-os-Montes
e Alto Douro, 5000-911 Vila Real, Portugal Centro de Estudos em Cincia Animal e Veterinria (CECAV),
Universidade de Trs-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal Rua do Barreiro, n 16, Sabroso,
5000-104 Vila Real, Portugal Clnica Veterinria da Trofa, Av. Paradela n 297, 4785 Trofa, Portugal
(Received 6 July 2005; accepted 20 October 2005)

Abstract This case report describes a highly pruritic, papular and crusted dermatitis affecting the dorsum of a
dog and microscopically diagnosed as dermatitis induced by Straelensia cynotis. Histologically, each papule was
characterized by a dilated hair follicle with marked pseudoepitheliomatous hyperplasia, perifollicular mucinosis
and an abundant mononuclear infiltration by plasma and mast cells. Each dilated follicle contained a larval mite.
A therapy including systemic ivermectins and oral antibiotic therapy was initiated, but the clinical response was
poor. To the best of the authors knowledge, this is the first report of straelensiosis in Portugal, and the second
in Europe.

Straelensiosis is a trombidiosis caused by larval mites

of Straelensia cynotis, a newer described aetiology for
a nodular dermatitis in dogs. Straelensiosis was first
identified in dogs in France by Le Net and collaborators as causing a nodular dermatitis. Fain and Le
Net published the morphologic characteristics of these
mites and proposed the classification of a new species:
S. cynotis, superfamily Trombidioid, family Leeuwenhoekiidae.1 The purpose of this case report is to describe
the clinical and histological features of another case of
straelensiosis in a dog.
A skin biopsy from a 3-year-old male cross-bred
outdoor sheepdog living in a rural area in the northern
region of Portugal that had a 6-month history of a
highly pruritic dermatitis was referred to the histopathology laboratory of the Veterinary Teaching Hospital
of Trs-os-Montes e Alto Douro University (UTAD).
Lesions consisted of alopecia, scaly erythematous skin
and papules scattered throughout the body (Fig. 1).
Dorsal areas including the head were the most severely
affected, whereas ventral abdomen and chest were the
least involved. According to the clinician, lesions started
as erythematous macules that rapidly developed into
papules, less than 1 cm in diameter, with suppuration and
crusts. Although the clinician suspected a parasitical
aetiology, all efforts to obtain parasites from the
nodules were unsuccessful because pressure applied on
Correspondence: Maria A. Pires, Centro de Estudos em Cincia
Animal e Veterinria (CECAV), Clinicas Veterinrias Universidade
de Trs-os-Montes e Alto Douro, 5001801 Vila Real, Portugal. Tel.:
+351 259 350637; Fax: +351 259 350480; E-mail: apires@utad.pt

the cutaneous papules and skin scrapings were reported

to be negative. Two other dogs with similar papular
dermatitis and similar lesion distribution lived in the
same household, but skin biopsies were taken only from
the dog reported here. Apart from the dermatitis, all
the dogs were healthy. Differential diagnosis included
sarcoptic mange, flea infestation and cutaneous myasis.
Skin samples were fixed in 10% formalin and processed
for light microscopy according to standard procedures.
Paraffin sections (2 m) were stained with haematoxylin
and eosin (H&E).
Histopathological examination revealed the presence
of dilated hair follicles with marked pseudoepitheliomatous hyperplasia, and perifollicular mucinosis.
An abundant mononuclear infiltration by plasma and
mast cells, as well as some neutrophils were seen surrounding affected follicles. Eosinophils were rare. The
follicular lesions were multifocal and consisted in a
degenerative and necrotic area nearby the parasites
mouthparts and pseudoepitheliomatous hyperplasia
in the remaining follicular epithelia. Some follicles
exhibited larval parasites surrounded by an eosinophilic
amorphous material, which sometimes presented focal
mineralized areas (Fig. 2). The intrafollicular parasites
had average dimensions of 549.4 252.78 m. Mites
had the mouthparts placed towards the dermis and, in
one lesion, a tubular structure compatible with a feeding tube or stylostome was also observed (Fig. 3). Barbs
were noted in the cuticle (Fig. 4). Some of the affected
follicles exhibited focal suppurative mural folliculitis
with neutrophils migrating into the sheath of the hair
follicle. The epidermis was hyperkeratotic, acanthotic,

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F Seixas et al.

Figure 3. Skin: tubular structure compatible with a feeding tube or

stylostome (arrow) directed towards the dermis. Bar = 100 m.

Figure 1. Nodular lesions with alopecia and erythema along the

dorsal region.

Figure 4. Skin: parasite displaying a striated cuticle (arrowheads)

with barbs (arrow). Bar = 50 m.

Figure 2. Skin: follicle bearing the parasite surrounded by an

eosinophilic amorphous material, which presents focal mineralized
areas. Bar = 200 m.

with spongiosis and serocellular crusts. The dermis

showed vascular ectasia, fibrosis and perivascular dermatitis with lymphocytes, plasma cells and mast cells.
These macro- and microscopic findings were found
to be consistent with previous descriptions of dermatitis

induced by S. cynotis by Le Net et al.1, therefore a tentative diagnosis of straelensiosis was made.
Recommended treatment included systemic ivermectin
(Virbamec; Virbac de Portugal Laboratorios LDA,
Almeirim, Portugal, 1 mg/kg, s.c., in the first week;
0.5 mg/kg, s.c., weekly, for 1 month) and oral antibiotic
therapy (amoxicillin-clavulanic acid, Clavamox; Bial
Laboratory, S. Mamede do Coronado, Portugal, 22 mg/
kg q 12 h, p.o. for 2 weeks). According to the clinician,
the clinical response to the therapy was minimal. A new
skin biopsy was taken 1 month later in order to follow
the cases evolution. The histological examination at
this time revealed follicular pseudoepitheliomatous
hyperplasia, dermal mucinosis, perivascular and
perifollicular dermatitis. Follicles were no longer dilated
and no mites were observed in the follicular lumina
(Fig. 5). There was a severe perifolliculitis and mural
folliculitis by plasma cells, mast cells and neutrophils.
Despite this, as the skin papules, crusts and pruritus
persisted, the owner decided to euthanize the animal.
No necropsy was performed.

2006 The Authors. Journal compilation 2006 European Society of Veterinary Dermatology

Straelensiosis in a dog

Figure 5. Skin: lesions observed after the treatment consisting of

pseudoepitheliomatous hyperplasia, dermal mucinosis, and diffuse
superficial dermatitis. Bar = 200 m.

Trombidiosis, or trombiculiasis, is defined as dermatitis caused by larval trombiculid mites18 commonly

found in soil, litter and other terrestrial habitat, being
part of a group poorly known taxonomically. Infection
is usually acquired in wild and semiwild landscapes.4,9
Many species remain undescribed and many known
species are inadequately described.10 Chigger nymphs
and adults from the families Trombiculidae and
Leeuwenhoekiidae are free-living, whereas the larvae
primarily parasitize free-living wild mammals, birds
and reptiles.1 4,8,11,12 On rare occasions, trombiculid
larvae accidentally parasitize domestic animals and
humans.1,4,8,11,12 Affected areas may reflect the chiggers
initial site of contact with the host,8,13 and commonly
tend to be confined to areas that contact plants or
the ground, such as the legs, feet, head, ears and
ventrum.1,5,9,12 Chigger infestations cause variable
degrees of local inflammation resulting from mechanical
action, hypersensitivity reactions and/or secondary
bacterial infections,6 but are not usually detrimental to
the overall health of the animal.6,8,13
Most trombidioid larvae are attached to the epidermis
and are easily detected as tiny, six-legged mites at
the base of hair tufts or in epidermal tunnels.1,5,9,14 As
opposed to most trombidioid infections, S. cynotis
larvae are in the follicular ostium.14 When larvae attach
to the skin, it injects its saliva, which is very rich in
proteolytic enzymes, thus causing the digestion of the
host tissues.2,5,14 The surrounding skin hardens and
a feeding tube called a stylostome is formed.4 The
digested material is then reabsorbed through this

83

structure. The nature of the stylostome is unknown,

but it is hypothesized that it derives from the salivary
secretions of the mites.10,13 This particular way of feeding was named extra-intestinal digestion and it seems
to be very common among the larvae of Trombiculidae, being reported for the first time for the genus
Straelensia by Fain and Le Net14. Upon completion of
feeding, the larvae detach from the stylostome and
return to the environment to complete their life
cycle.2,11,13
The lesions of dogs infected with S. cynotis were
reported for the first time in 1999 by Le Net15. Le Net
et al.1 reported the occurrence of 12 cases of infection
in dogs living in rural areas in the south and southwest regions of France. These investigators described
the macro and microscopic features of the clinical
lesions and characterized the morphology of the
agent. They postulated that the natural host of S. cynotis
is the fox, and the nymphs and adults are believed to
live in foxs dens; the dog is probably an occasional,
incidental host. In this particular case, the sheepdog
and the other cohabitant dogs regularly visited
prairies and woods accompanying the flock. It is
therefore possible that all these dogs came in contact
with fox dens, which could be suggestive of the parasites source, as apparently this is not a contagious
dermatitis.
The development of the larvae within the hair follicle
of the host, with production of cutaneous nodules,
seems to be unique to the genus Straelensia.14 As larvae
live in the hair follicles and are attached to their wall by
its chelicerae, skin scratching or pressures applied on
the cutaneous nodules do not release any organism.
Microscopically, the follicular pseudoepitheliomatous
hyperplasia and the dermal mucinosis are considered
pathognomonic lesions and are probably due to tissue
reaction to larval secretions.1 Although Le Net et al.1
observed a slight infiltration of inflammatory cells
in the dermis with the absence of mast cells, in the
case reported here there was a severe perifollicular
infiltration by mast cells, which are probably responsible for the pruritus. It should be noticed that from the
reported 12 French cases, only one was pruritic, a fact
that was attributed to flea and lice infestation. Most
trombiculidiasis are typically associated with a pruritic
dermatitis attributed to an allergic reaction to salivary
secretions.1 It is possible that dogs exhibit intraspecies
variability with respect to hypersensitivity to chigger
infections, as it is suspected in some cats trombiculiasis.8
In conclusion, the first case of straelensiosis in a dog
in Portugal is described. This case was briefly described in
a letter to the editor.16

AC K N OW L E D G E M E N T S
The authors thank Prof. Lluis Ferrer for his valuable comments on the case, Mrs Lgia Bento for technical assistance and Luis Mendanha for the English
revision.

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R E FEREN CES
1. Le Net J-L, Fain A, George C et al. Straelensiosis in dogs:
a newly described nodular dermatitis induced by Straelensia
cynotis. The Veterinary Record 2002; 150: 205 9.
2. Lowenstine LJ, Carpenter JL, OConnor BM. Trombiculosis in a cat. Journal of American Veterinary Medicine
Association 1979; 175: 289 92.
3. Soulsby EJL. Helminths, Arthropods and Protozoa of
Domesticated Animals, 7th edn. Lea and Ferbiger, 1982.
4. Bowman DD, Lynn RC. Georgis Parasitology for Veterinarians, 6th edn. W.B. Saunders Co, Philadelphia, USA,
1995.
5. Hargis AM. Integumentary system. In: Carlton WW,
McGavin MD eds. Thomsons Special Veterinary Pathology,
2nd edn. Mosby, Philadelphia, USA, 1995.
6. Jones TC, Hunt RD, King NW. Veterinary Pathology,
6th edn. Lippincott: Williams & Wilkinson, St Louis,
USA, 1997.
7. Encinas Grandes A. Artrpodos. In: Cordero del Campillo M, Rojo Vazquez FA, Martinez Fernandez AR,
Sanchez Acedo MC, Hernandez Rodriguez S, Navarrete
Lopez-Cozar I, Diez Baos P, Quiroz Romero H, Carvalho
Varela M eds. Parasitologia Veterinria. Madrid: McGrawHill-Interamericana 1999: 150.
8. Takahashi M, Misumi H, Urakami H et al. Trombidiosis
in cats caused by the bite of the larval trombiculid mite
Helinicula miyagawai (Acari: Trombiculidae). The Veterinary Record 2004; 154 (15): 471 2.

9. Scott DW, Miller WH, Griffin CE. Parasitic skin lesions.

In: Muller and Kirks Small Animal Dermatology, 6th
edn. Philadelphia: W.B. Saunders, 2001: 40710.
10. Zhang Z-Q. Biology and ecology of trombidiid mites
(Acari: Trombidioidea). Experimental Applied Acarology
1998; 22: 13955.
11. Yager JA, Scott DW, Wilcocke BP. The skin and appendages.
In: Jubb KVF, Kennedy PC, Palmer N eds. Pathology of
Domestic Animals, 4th edn, Vol. 1. San Diego: Academic
Press, Inc., 1993: 690.
12. Greene RT, Scheidt VJ, Moncol DJ. Trombiculiasis in a
cat. Journal of American Veterinary Medicine Association
1986; 188: 10545.
13. Little SE, Carmichael KP, Rakich PM. Trombidiosisinduced dermatitis in white-tailed Deer (Odocoileus
virginianus). Veterinary Pathology 1997; 34: 3502.
14. Fain A, Le-Net J-L. A new larval mite of the genus Straelensia Vercammen-Grandjean and Kolebinova, 1968.
(acari: Leeuwenhoekiidae) causing nodular dermatitis of
dogs in France. International Journal of Acarology 2000;
26 (4): 33945.
15. Le Net J-L, Fain A, George C et al. Dermatitis in dogs
induced by larval mite (Acari) of the genus Straelensia
(Prostigmata: Leeuwenhoekiidae) in France. Proceedings of the 24th World Small Animal Veterinary
Association Congress. Lyon, France 1999, September 23
to 26.
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dog in Portugal. Veterinary Record 2003; 153: 5.

Rsum Ce cas dcrit une dermatose trs prurigineuse, papuleuse et croteuse, atteignant le dos des chiens et
dnomme dermatite Straelensia cynotis, Histologiquement, chaque papule tait caractrise par un follicule
dilat, une hyperplasie marque, pseudopithliomateuse, une mucinose prifolliculaire, et une infiltration massive
mononucle par des plasmocytes et des mastocytes. Chaque follicule pileux dilat contenait une larve dacarien.
Un traitement avec livermectine par voie systmique et un antibiotique orale a t mis en place, mais la rponse
clinique a t mauvaise. A la connaissance des auteurs, il sagit de la premire description de straelensiose au
Portugal et de la seconde en Europe.
Resumen A continuacin describimos un caso de dermatitis papular, altamente pruritica y con costras que
afect el dorso de un perro y que tras examen microscpico fue diagnosticada como una dermatitis producida
por Straelensia cynotis. Histolgicamente, las ppulas estaban formadas por un folculo piloso dilatado con marcada hiperplasia pseudoepiteliomatosa, mucinosis perifollicular y abundante infiltrado mononuclear de clulas
plasmticas y mastocitos. En cada uno de los folculos dilatados se observ una larva del caro. La respuesta
clnica a la terapia que inclua ivermectina y antibiticos fue pobre. Basndonos en los datos conocidos por los
autores, este es el primer caso descrito en la literatura de Straeleniosis en Portugal y el segundo en Europa.
Zusammenfassung Dieser Fallbericht beschreibt eine hochgradig juckende, papulre und krustende Dermatitis
am Rcken eines Hundes, die mikroskopisch als eine von Straelensia cynotis induzierte Dermatitis diagnostiziert
wurde. Histologisch war jede Papel charakterisiert durch ein dilatiertes Haarfollikel mit einer markanten
pseudoepitheliomatsen Hyperplasie, mit perifollikulrer Mucinose und reichlich mononuklerer Infiltration
von Plasma- und Mastzellen. Jedes dilatierte Haarfollikel beinhaltete die Larve einer Milbe. Eine Behandlung
mit systemischen Ivermectinen und oralen Antibiotika wurde initiiert, aber die klinische Antwort war gering.
Soweit den Autoren bekannt ist, handelt es sich hierbei um den ersten Bericht einer Straelensiosis in Portugal
und den zweiten in Europa.

2006 The Authors. Journal compilation 2006 European Society of Veterinary Dermatology