Sarcoids are locally invasive fibroblastic skin tumours.

They can appear any where on the body however there are a few places that they are seen more than others:

• Around the eyes
• In the axilla (under the front legs)
• Under the abdomen
• Around the sheath
• On the thigh area
• Groin

These are often areas which are pre-disposed to trauma.

Sarcoids can look very variable, but there are 6 main types:

Occult

Grey hairless areas often circular

Verrucose

Wart like grey scabby and sometimes ulcerated

Nodular

Nodules of varying sizes under the skin. Some are attached to the skin and others move freely under it

Fibroblastic

Fleshy lumps which are often ulcerated and sometimes hang by a pedicle

Mixed

A mixture of two or more sarcoids

Malevolent

These are rare in the UK, the most aggressive type. It spreads through the skin and sometimes along lymph vessels, with lines of tumour tissue intersected with nodules and ulcerative lesions.

Some sarcoids will never change, others will increase in size and number and others can change into fibroblastic sarcoids. They are VERY UNPREDICTABLE.

There is increasing evidence that bovine papilloma virus (BPV) types 1 and 2 are the major cause of sarcoids.

There is also now reasonable evidence to suggest that there is a genetic susceptibility in some horses which get sarcoids

Treatment

We need to kill 100% of the cells in the lesion.

Your veterinary surgeon will come and examine any lesion that you suspect may be a sarcoid. They will then ask you to take some photographs of the lesion and we will refer these to Liverpool University where Professor Knottenbelt will decide what the best treatment for each lesion would be.

Treatment chosen will depend upon

• Type and location of sarcoid
• Previous treatments and history
• Complicating factors i.e. pregnancy
• Relative value of the horse/ cost of treatment

Topical cytotoxic cream
Very effective treatment. Cream from the University of Liverpool used for several applications to sarcoid and it dies off usually within 6-8 weeks

Chemotherapy
Cytotoxic drugs are injected into the centre of the lesion

BCG injection
This works well on nodular and fibroblastic sarcoids but carry risks

Cryosurgery
The sarcoid is frozen again with limited success

Surgical removal
Can be effective on small lesions but there is a high risk that the sarcoid can come back and be more aggressive.

Radiation
This is only available at two places in the UK and expensive but has a very high success rate. It is usually only used on small sarcoids or difficult areas such as around the eyes.

Prevention

The only things you can do are to have a good fly repellent as it is thought that they are the possible carriers, especially around wounds.