Allergic dermatoses

Question 1

Atopic Dermatitis (AD)
Definition

Answer 1

Inflammatory and PRURITIC skin disease with strong genetic predispositions.

Question 2

Animals with AD tend to develop ___ - mediated response against _____.

Answer 2

Develop IgE mediated response against environmental allergens.

Question 3

pathophys of the pruritis of AD

Answer 3

absorption of allergen (skin) -> langerhans cells present to TH cells -> dorsal root ganglion - > brain -> meanwhile immune cells are communicating with each other and are increasing inflammation.

Question 4

patients with AD have mutation in the ____ gene

Answer 4

filaggrin

Question 5

Barrier function

dogs with AD have decreased barrier function d/t decreased ___ in between epithelial cells -

Answer 5

ceramides

Question 6

important cytokine that can be targeted with treatment of AD

Answer 6

IL31 ***

Question 7

clinical features of AD

Answer 7

1-3 yo
seasonal pruritis
ventrum, face, feet, perianal area
signs of inflammation (what are they)

Question 8

Treatment options for AD

Answer 8

SYMPTOMATIC
- antihistamines
- GCs (ORAL! short acting; don't use long acting injeectable)
* Temaril P = antihistamine + pred
- omega 3 FAs
- topical, bathing
SPECIFIC
- allergen-specific desensitization therapy
- cyclosporine (Atopica)
- Oclacitinib (Apoquel)

Question 9

What is a side effect in dogs secondary to too much steroids? (aka bad news)

Answer 9

Calcinosis cutis - disrupts skin, plus you’re suppressing immune system, increased risk of 2’ bacterial infections

Question 10

Why are free fatty acids helpful for AD?

Answer 10

helps to restore the integrity of the skin. Incorporate into your long-tern treatment.

Question 11

Most ‘allergy shampoos’ contain ____

Answer 11

hydrocortisone

Question 12

Potent topical steroids should be managed like ____.

Answer 12

systemic steroids; because they cant disrupt the skin! make sure to follow label directions.

Question 13

The goal of allergy immunization is to ___

Answer 13

desensitize the patient to allergens

Question 14

___ is the gold standard for AD testing

Answer 14

intradermal testing

Question 15

Which drugs can interfere with intradermal allergen test results?

Answer 15

antihistamines

corticosteroids

Question 16

Allergy immunotherapy targets ___ and __ cells (theoretically

Answer 16

T helper & mast cells

Question 17

Allergy drops are administered to the animal ___

Answer 17

under the tongue, every day

Question 18

Animals that failed to respond to allergy ____ tend to respond to allergy ___

Answer 18

shots; drops

Question 19

cyclosporine (atopica) reduces pruritis by ___

Answer 19

blocking calcineurin -> block transcription of inflammatory mediators

Question 20

cyclosporine is metabolixed by ____

Answer 20

CYP450

Question 21

Do not give apoquel to patients under ____ age

Answer 21

12 mos

Question 22

Apoquel is a ___ inhibitor

Answer 22

JAK 1 & 2. Provides anti-pruritic and immune-modulatory drug

Question 23

Mechanism of action of cytopoint is ___

Answer 23

Anti-IL 31 monoclonal antibody. IL 31 is a major player in pruritis

Question 24

Food allergies (cutaneous adverse food reactions) are mediated by what immunologic reactions?

Answer 24

IgE mediated (type I and type III) 
Type IV

Question 25

Mechanisms of defense of the gut

Answer 25

``` IgA paneth cells (secrete antimicrobial peptides) epithelial tight junctions m cells lymph nodes ```

Question 26

dermatologic sites affected by food allergies

Answer 26

eyes, mouth, distal limbs, ventrum, bum.

Question 27

key distinguishing factor between AD (environmental allergies) and food allergies

Answer 27

seasonal vs. non seasonal! (usually)

Question 28

food allergy dogs commonly present with

Answer 28

otitis recurrent pyodermas, GI. | uncommonly, can see vasculitis, urticaria, erythema multiforme (target skin lesions)

Question 29

blood allergy test [are/are not] reliable for food allergy?

Answer 29

NOT

Question 30

diagnosis of food allergies

Answer 30

elimination diet trial, provocative exposure

Question 31

Treatment of food allergy

Answer 31

change the diet avoid treats, flavored drugs/supplemented treat the pruritis (initially) GCs, apoquel, cytopoint. have to take off after a while to see if your diet is working

Question 32

Mechanism by which hydrolyzed diets work

Answer 32

the peptide bonds of large proteins so that they become <10KDaltons -> don't activate IgE on mast cells

Question 33

grain- free, organic foods [are/are not] good for treating food allergies

Answer 33

NOT. often have cross-contamination in manufacturing process

Question 34

treatment for food allergies

Answer 34

``` pyoderma - abx otitis - otomax - miconazole - osurnia pruritis - cytopoint - temaril p - aproquel food trial - Dr. mel has success with rabbit sweet potato apple ```