References
Management of canine atopic dermatitis
Abstract
Canine atopic dermatitis can present in two different ways — acute versus chronic — which require different treatment. When dealing with an acute flare, it is important to try and identify and eliminate the trigger and then provide fast-acting topical and/or systemic treatment. The treatment of chronic atopic dermatitis differs as it includes identification of flare factors, treatment of pruritus and prevention strategies. For long-term treatment of pruritus, there are currently four licenced prescription options available: oral glucocorticoids, oral ciclosporin, oral oclacitinib and injectable lokivetmab. The key prevention strategy for canine atopic dermatitis is allergen-specific immunotherapy and it is currently the only treatment that may induce complete remission of clinical signs. Alongside treatment for cases of canine atopic dermatitis, it is important to effectively communicate with clients in order to achieve compliance and medical adherence.
Canine atopic dermatitis (CAD) is a genetically predisposed inflammatory and pruritic skin disease with easily recognisable clinical signs; the appearance of clinical signs is associated with immunoglobulin E (IgE) antibodies, most commonly against environmental allergens (Olivry et al, 2015a). The complex pathogenesis of CAD is not fully understood; it has been implied from human medicine that atopic dogs may have epidermal dysfunction, causing increased penetration of environmental allergens and pathogens. Consequently, this leads to a T helper 2 (Th2) cell-mediated inflammation and further perturbation of the epidermis (Elias and Schmuth, 2009; Marsella et al, 2011; Santoro et al, 2015). In addition, atopic dogs have microbial dysbiosis of their skin microbiome, making them more susceptible to developing secondary infections (Santoro et al, 2015; Pierezan et al, 2016).
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