Pruritic dermatitis associated with Dirofilaria (Nochtiella) repens microfilariae in the blood was diagnosed in 22 dogs from Fermo (Central Italy). According to the history, previous unsuccessful treatments with corticosteroids, antibiotics, restricted diet, flea control, levamisole and ivermectin were recorded in 17 dogs (77.3%). The combined filtration tests and antigen tests, performed during the study, were negative for Dirofilaria immitis and Acanthocheilonema reconditum in each case. Dermatological lesions included erythema, papules, single or multifocal alopecia, eczema, lichenification, crusting and nodules. All dogs had pruritus. Concurrent babesiosis was diagnosed in the blood smears of each case (100%), and 60% of the dogs were found to be carriers of canine granulocytic ehrlichiosis (CGE). Three dogs (13.6%) were positive for leishmaniosis. Eradication of the concurrent infections followed by specific macro-and microfilaricide treatment led to complete recovery from the dermatological syndrome. The main conclusion of the study is that D. repens infection can be more pathogenic than is currently considered, and it is apparently an opportunistic disease with serious dermatological consequences.