title: An update on the treatment of canine atopic dermatitis.
abstract: Canine atopic dermatitis is a common skin disease seen in veterinary clinical practice. Several factors appear to contribute to the cutaneous inflammation and pruritus. The therapeutic strategy should focus on control of those factors that can be identified and for which interventional measures are feasible; these include ectoparasites, bacterial/fungal infection and dietary hypersensitivity. Ectoparasites, particularly fleas, are not the cause of atopic dermatitis, but they are a confounding factor, which can exacerbate pruritus, and preventative measures are therefore indicated. Bacterial and yeast infections are frequently associated with atopic dermatitis and initial systemic and/or topical therapy should be considered, followed by regular topical treatment for preventing relapse. Concurrent dietary hypersensitivity should be investigated by undertaking an elimination/provocation trial, followed by feeding of a hypoallergenic diet where appropriate. Depending on the severity of the clinical signs of atopic dermatitis and the willingness and expectations of owners, symptomatic treatment and/or specific interventional therapy for environmental allergy (allergen avoidance, allergen-specific immunotherapy) may be implemented. Symptomatic treatment includes use of glucocorticoids (systemically or topically), ciclosporin and oclacitinib. Other treatment modalities of lower or less proven efficacy include antihistamines, dextromethorphan, fatty acids, feline interferon-omega, misoprostol, pentoxifylline, specific serotonin re-uptake inhibitors and tricyclic antidepressant drugs. The therapeutic approach should be reviewed at regular intervals and tailored to the individual's needs. A successful long-term outcome can usually be achieved by combining the various treatment approaches in a way that maximises their benefits and minimises their drawbacks.
authors.affiliation: Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, Karditsa GR-43100, Greece. Electronic address: msarido@vet.uth.gr.
authors.forename: Manolis N
authors.initials: MN
authors.lastname: Saridomichelakis
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA; Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC 27606, USA.
authors.forename: Thierry
authors.initials: T
authors.lastname: Olivry
mesh_terms: D000818:Animals; D003876:Dermatitis, Atopic / Q000662:veterinary*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D005938:Glucocorticoids / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; D011743:Pyrimidines; D013449:Sulfonamides; C588062:oclacitinib
keywords: Atopic dermatitis; Ciclosporin; Dog; Glucocorticoids; Oclacitinib