Successful Treatment of Severe Idiopathic Inflammatory Ulcerative Lesions Affecting the Entire Head Region in a Dog with Topical NPH-Insulin

In this case report, the treatment of hyperkeratotic and ulcerative skin lesions affecting the entire head region in a 2-year-old spayed Akbash mixed breed bitch with topical NPH-insulin is discussed. The dog was found injured on the street and brought to a private veterinary clinic; clinical and histopathological examinations determined that the lesions were not related to a specific disease and were caused by an idiopathic inflammatory process. No abnormal findings were detected in routine hematological, biochemical analyses, and radiographic imaging. The treatment protocol included the topical application of NPH-insulin cream, prepared at a concentration of 4 IU/g, to the lesions. During this treatment process, the cream was applied daily for the first 15 days and every other day for the subsequent 10 days. Significant improvement in the skin lesions was observed by the 10th day, with a reduction in hyperkeratosis, and the lesions began to improve. By the 25th day of treatment, it was determined that alopecia had regressed and hair had started to grow again, and on the 53rd day of control, it was observed that the skin lesions had completely healed and hair growth had been completed without any problems. This case suggests that topical NPH-insulin may be an effective option for the treatment of idiopathic inflammatory skin lesions.Cite this article as: Özaydın, İ., Şekerci Özel, G., & Erkılıç, E. E. (2025). Successful treatment of severe idiopathic inflammatory ulcerative lesions affecting the entire head region in a dog with topical NPH-insulin. Acta Veterinaria Eurasia, 51, 0006, 10.5152/actavet.2025.25006.