Reliability of different sets of criteria in diagnosing canine atopic dermatitis applied to a population of 250 dogs seen in a veterinary teaching hospital

Abstract

Background -Different sets of criteria are available in veterinary dermatology for the diagnosis of canine atopic dermatitis (cAD); there are limited data to assess their reliability.Hypothesis/Objectives -The aim of this study was to assess the discriminative and predictive ability of four sets in diagnosing cAD in a population of dogs with different skin diseases.Animals -Two hundred and fifty dogs examined in the dermatology unit of a veterinary teaching hospital.Methods and materials -Dogs were diagnosed with cAD, flea infestation (FI), flea bite hypersensitivity (FBH), sarcoptic mange (SM) and other skin diseases (OD). FI, FBH and SM were pooled in one group of dermatoses mimicking cAD (MD). All nonatopic dogs were grouped as a "global population" (GP). Four criteria sets were applied to all dogs. For each set of criteria, sensitivity, specificity, positive and negative predictive values (PPV, NPV), likelihood ratios (LR) and diagnostic odds ratio (DOR) were calculated.Results -When applied to the GP, sensitivities ranged from 54 to 83%, specificities from 68 to 75% and PPVs from 35 to 43%. NPVs ranged from 87 to 94%. LRs and DORs were poor. When applied to MD, sensitivities remained unchanged, specificities and PPV were mildly higher, whereas NPVs were mildly lower and LRs and DORs were comparable.Conclusions and clinical importance -This study showed that each set of criteria had a low diagnostic reliability when used alone. The use of more discriminant criteria integrated into a thorough clinical approach excluding MDs should be considered.

A Randomized Controlled Trial to Evaluate the Impact of a Novel Probiotic and Nutraceutical Supplement on Pruritic Dermatitis and the Gut Microbiota in Privately Owned Dogs

“…The International Committee for Allergic Diseases in Animals (ICADA) has outlined three ways in which a CAD diagnosis can be made by trained practitioners: (1) elimination of similar skin conditions through formal examination and work-up; (2) interpretation of clinical history and features based on diagnostic criteria sets; and (3) allergy testing for confirmation and allergen identification [1]. Multiple diagnostic criteria sets exist to aid in the interpretation of clinical features associated with CAD; however, Brément et al compared Willemse [145], Prélaud [146], and Favrot (both set 1 and set 2) [88] and demonstrated that when used in isolation all criteria sets were unreliable [147]. Thus, it is recommended that all three diagnostic approaches outlined by ICADA are used in combination for a more accurate assessment, which was not possible in the present investigation [1,11,147].…”

Snail Mucus Filtrate Reduces Inflammation in Canine Progenitor Epidermal Keratinocytes (CPEK)

“…The International Committee for Allergic Diseases of Animals (ICADA) classified canine atopic dermatitis (cAD) as a genetically predisposed inflammatory and pruritic allergic skin disease with many possible manifestations; several clinical features are associated with IgE antibodies that are most frequently directed against environmental allergens [ 1 , 2 ]. cAD is subjective by the interaction of both, genetic and environmental factors, by abnormalities of the immune system, by its interaction with the nervous system and by defects in the epidermal barrier.…”

Polyphenols and Cannabidiol Modulate Transcriptional Regulation of Th1/Th2 Inflammatory Genes Related to Canine Atopic Dermatitis

“…In veterinary dermatology practice, canine atopic dermatitis (AD) is a multifactorial allergic disease that affects up to 27% of dogs; it is associated with immune and abnormal skin barrier dysfunction and it is one of the primary causes of pruritus (1). Many pharmacological options for its treatment already exist; however, due to elevated costs, side effects, and/or a long lag phase, treatments based on natural compounds are constantly being developed (2).…”