This section is on equine skin, cosmetics, hygiene, and ears. These are all questions that have been submitted or that I have been inspired to talk about because of a question submitted. If you have any topics that you would like to have discussed please feel free to email me with the topic or question.
These are probably the structures called ergots and chestnuts. Ergots are on the underside if the fetlock joint and are a hairless, small mass of tough tissue very similar to the pad of a dog. The chestnut is higher up the forearm and varies in exact poistion. It too is a hairless, small mass of tough tissue very similar to the pad of a dog. I can think of and could find no abnormal conditions that give such masses, but it wouldn't hurt to ask your vet to look at them the next time he or she visits just to make sure.
Horses teeth grow continually. Usually normal wear from grinding food keeps the teeth from getting too long. If, however, the teeth are used unevenly some parts of the teeth wear at different rates than others. This creates long parts of teeth that if they get too long can cut the lip and cheek. Floating is the filing of these teeth parts down to an acceptable level.
Reading in all the large animal medical textbooks I can find and talking to the large animal clinicians on staff here I have found very little info for you. The best idea I can come up with from the input from all these sources is some type of allergy. Since it is seasonal and seems to go away only to reappear at the same time next year, some type of allergic response to an environmental factor( such as a certain plant,mold, food source, etc) is suspected. The concern with swelling sheaths is always some type of cancer (melanoma or squamous cell carcinoma). But cancers don't go away and return, go away and return, so cancer is highly unlikely given the history. Other than some allergic response there is very little that would account for the seasonal swelling. To help indentify if it is an allergic response, try keeping the environment as consistent as possible. Allergies are very hard to identify because like in people they can be a response to anything. Do you typically vaccinate him near this time of year? Some vaccine reactions mimic other allergic reactions and this could be his manifestation of a vaccine reaction. How about dewormers? Do you use a different dewormer at this time of year? Food -- is there something different about this time of year in regards to diet (certain type of hay, molding of the hay as winter progresses, change in grain type or supplier, etc). Aside from those factors in your control, there is always the nature factor -- growth of certain plants and associated pollen, growth of certain molds and yeasts, etc.
Strep equi is certainly a prime candidate for a chronic infection. It loves to form abscesses and hang around for a long time. The classical disease that it causes is strangles and most of the information about the organism comes from research into this disease. Here is one farily informative site on strangles with some good information about the strep organism itself:
http://www.thehorse.com/0597/strangles0597.html
There are other streps that can cause chronic infection and without definitive proof one can not be sure that it is strep equi. The other thing that must be considered is that with a chronic infection it is highly likely that there is a mixed infection (a variety of bacteria +/- fungi). A biopsy is certainly an excellent idea with histopathologic analysis as well as a culture and sensitivity taken from the biopsy sample. If you have tried topical treatments and they have not been successful then I think systemic antibiotics would be the next logical course to take. If you do opt to use systemic antibiotics than I would strongly recommend using intravenous antibiotics via a catheter rather than trying to give the antibiotics intramuscularly. The intramuscular route is difficult to use to deliver the amount of antibiotics needed for the length of time needed not to mention very painful for the horse. Given an infection of this duration you are looking at weeks to months of antibiotics +/- antifungals to completely clear the infection.
I have researched and answered these questions to the best of my ability. But I am human and make mistakes. If there is any part of my answer that you feel is incorrect, please let me know. The last thing I want is to disseminate false or incorrect information.