The patient, a 10-year-old male neutered mixed breed dog, was presented to Cornell’s Dermatology Service for a recheck concerning a four-year history of recurring dermatologic events including pruritus, scaling, hair loss and malodorous skin. The patient was adopted at approximately two years of age and his recorded medical history was inconsistent. He had been treated for his dermatologic issues periodically with 3 different courses of Cephalexin, given at subtherapeutic doses for varying durations ranging from 10 days to 6 weeks. These courses would provide temporary relief, but the signs would inevitably return. The patient was first presented to Cornell’s Dermatology Service with the complaint of progressive dermatologic issues. Historically, his clinical signs were isolated to his ventrum but had recently spread to his flanks and dorsum. His clinical signs were non-seasonal and were accompanied by periods of lethargy. Impression cytology of the dorsum revealed cocci and degenerative neutrophils. A presumptive diagnosis of staphylococcal dermatitis was made, and the patient was treated with cephalexin, 25 mg/kg twice daily, for 5 weeks. The patient’s skin again improved as did his energy but, upon completion of the antibiotics, his signs again returned. On recheck examination 3 months later, the patient was quiet but alert and responsive. Physical examination showed a brittle and thin hair coat, generalized dry skin with scaling and alopecia of the dorsal aspect of the tail. His ventrum was alopecic with hyperpigmentation and comedones. Bilaterally symmetric wasting of the temporalis muscles was also noted. Tape cytology of the ventrum revealed results consistent with a malassezia infection. Bacterial folliculitis of the dorsum was again presumptively diagnosed. Given the nature and persistence of the clinical signs, a complete blood count (CBC), chemistry panel and thyroid panel were submitted. While results were pending, the patient was again discharged with cephalexin (same dose and frequency as previously described) as well as Triz-Chlor 4% mousse to be applied to his ventrum once daily. Results of the CBC and chemistry were largely within normal limits, save for a markedly increased cholesterol and a very mild anemia. The thyroid panel revealed severely decreased levels of free and total thyroxine and elevated levels of thyroid stimulating hormone. Treatment for his newly diagnosed hypothyroidism was pursued through his primary DVM. This case is a great representation of the importance of regular blood work and screening for common diseases in our geriatric patients. This presentation will discuss the relationship between hypothyroidism and bacterial folliculitis and their respective treatments.