A novel non‐azole topical treatment reducesMalassezianumbers and associated dermatitis: a short term prospective, randomized, blinded and placebo‐controlled trial in naturally infected dogs

Abstract

Background -Malassezia yeast overgrowth on the skin is a common and often recurrent cause of dermatitis in dogs; it can be an exacerbating factor of atopic dermatitis. Anti-fungal drugs have been a standard treatment, but there is some concern that resistance may be evolving in a spectrum of Malassezia species. Safe, efficient and easy-to-use alternatives are needed.Objectives -To assess if a commercially available topical non-azole solution applied to paws affected by Malassezia-associated dermatitis (MAD), could ameliorate Malassezia numbers and associated signs over a short term (14 day) trial. Animals -Eighteen dogs with MAD affecting at least two paws.Methods -The study design was prospective, randomized, blinded and placebo-controlled, using a split-body protocol. Dogs were treated once daily with the test solution on one paw and placebo on the other. Dogs were examined at days 0 and 14 AE 3. The primary end-point was Malassezia numbers assessed cytologically. Secondary end-points were clinical scores for lesion severity and pruritus as assessed by a pruritus Visual Analog Scale (PVAS). Owner compliance and adverse effects were assessed.Results -There was a statistically significant reduction in Malassezia numbers and clinical scores for paws treated with the test solution versus placebo. No statistical difference in PVAS was found.Conclusion -Daily topical application of the test solution was effective in reducing the Malassezia burden, as well as improving clinical scores in dogs with MAD of the paws. No adverse effects were reported and owners described the product as either "easy" or "very easy" to use.

Malassezia: Zoonotic Implications, Parallels and Differences in Colonization and Disease in Humans and Animals

“…With increased recognition of azole resistance in Malassezia species, there has also been an expansion in the investigation of alternative treatment approaches, including photodynamic therapy, natural products, antifungal peptides and proteinase inhibitors [ 443 , 454 , 455 , 456 , 457 , 458 , 459 ].…”

Malassezia Yeasts in Veterinary Dermatology: An Updated Overview

“…For canine cases where topical therapy is ineffective or impractical, there was "moderate" evidence for the use of ketoconazole at 5-10 mg/kg orally once or twice daily; and itraconazole at 5 mg/kg orally once daily or two consecutive days per week (reviewed by Bond et al, 2020). Recently, the clinical and cytological effects of a once daily application of a leave-on spray formulation containing zinc, ethyl lauroyl arginate, laureth-9, urea, panthenol, glycerine and butylene glycol (Aptus R Derma Spot On Concentrate TM , Orion Pharma Animal Health, Sollentuna, Sweden) were evaluated in a randomized, blinded, controlled study of 18 dogs with chronic pododermatitis associated with Malassezia yeasts (Sjostrom et al, 2018). When compared with placebo treatment of the contralateral foot, reduced yeast counts from the actively treated foot were associated with a reduction in clinical scores.…”

Performance of Daily Pads Containing Ophytrium and Chlorhexidine Digluconate 3% in Dogs With Local Cutaneous Bacterial and/or Malassezia Overgrowth

“…There is no control group in this study, which is the main limitation of this trial. Nonetheless, some studies on similar clinical conditions with a placebo or a vehicle group, indicated few resolutions in the placebo group compared with the treated group after 2 weeks of application (22,23), even with shampoos where a mechanical effect on microbial count is suspected. Another study, involving an antifungal shampoo vs. a physiologic one showed a significant difference just after one shampoo lasting up to 4 days following the application of the antifungal shampoo whereas no significant difference was observed with the physiologic shampoo (24).…”