Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification

Abstract

BackgroundCanine atopic dermatitis (AD) is a common, genetically predisposed, inflammatory and pruritic skin disease. The variation in clinical presentations, due to genetic factors, extent of the lesions, stage of the disease, secondary infections, as well as resemblance to other non-atopic related skin diseases, can complicate a diagnosis of canine AD. A sub-group of the International Committee for Allergic Diseases in Animals (ICADA) was tasked with the development of a set of practical guidelines that can be used to assist practitioners and researchers in the diagnosis of canine AD. Online citation databases and abstracts from international meetings were searched for publications related to the topic, and combined with expert opinion where necessary. The final set of guidelines was approved by the entire ICADA committee.ResultsA total of 81 publications relevant for this review were identified. The guidelines generated focus on three aspects of the diagnostic approach:Ruling out of other skin conditions with clinical signs resembling, or overlapping with canine AD.Detailed interpretation of the historical and clinical features of patients affected by canine AD.Allergy testing by intradermal versus allergen-specific IgE serum testing.ConclusionsThe diagnosis of canine AD is based on meeting clinical criteria and ruling out other possible causes with similar clinical signs. Flea combing, skin scraping and cytology should be performed, where necessary, as part of a thorough work-up. Elimination diet trials are required for patients with perennial pruritus and/or concurrent gastrointestinal signs. Once a clinical diagnosis of canine AD is made, allergy testing can be performed to identify potential causative allergens for allergen-specific immunotherapy.

Concurrent development of generalised demodicosis, dermatophytosis and meticillin‐resistant Staphylococcus pseudintermedius secondary to inappropriate treatment of atopic dermatitis in an adult dog

“…Canine AD is a common, genetically predisposed, inflammatory and pruritic skin disease with varied clinical features most commonly associated with IgE antibodies to environmental allergens (Halliwell 2006, Miller and others 2013, Hensel and others, 2015). There are no pathognomonic clinical signs to definitively diagnose AD on presentation (Hensel 2015); therefore, a thorough and regimented diagnostic plan is imperative for diagnosing AD.…”

“…Several reports illustrate the association among canine AD, bacterial pyoderma (Simou and others 2005, Hensel 2015) and meticillin-resistant Staphylococcus spp. (Bannoehr and Guardabassi 2012, Beck and others 2012, Santoro and others 2015).…”

Longitudinal Evaluation of the Skin Microbiome and Association with Microenvironment and Treatment in Canine Atopic Dermatitis

“…Dogs with cAD were included in the study by fulfilling standardized criteria (5 criteria of Favrot, Favrot et al, 2010) and by ruling out dermatoses with similar presentations as depicted by Hensel et al . (Hensel et al, 2015) based on dermatologic examination and clinical histories. Dermatologic examination in all patients involved, but was not limited to, skin and otic cytology, flea combing/direct examination, and skin scraping.…”

Effectiveness of regionally-specific immunotherapy for the management of canine atopic dermatitis

“…Affected dogs often exhibit pruritus of the face, pinnae, feet, axillae, and inguinal region [2]. Secondary otitis externa, staphylococcal pyoderma and Malassezia dermatitis frequently develop in atopic dogs.…”