Canine atopic dermatitis

Question 1

CAD is genetically predisposed inflammation and pruritic allergic skin disease. What hypersensitivity is it and what antibodies are associated with it?

Answer 1

Type 1 + 4 hypersensitivity

IgE

Question 2

How can skin barrier function be measured?

Answer 2

Transepidermal water loss

Question 3

CAD may be seasonal, perinneal or both. What is perinneal?

Answer 3

Recurring

Question 4

Name the 2 primary lesions seen with CAD

Answer 4

Erythema
Papules
(Alopecia, saliva staining etc all secondary)

Question 5

How is CAD diagnosed?

Answer 5

Diagnosis of exclusion

Favrot’s criteria - onset <3, indoor dogs, steroid responsive, front feet affect etc

Question 6

Which 2 derm drugs interact with each other and should be avoided?

Answer 6

Itraconazole and ciclosporin

Question 7

Part of CAD treatment is improving the skin barrier function. How is this done?

Answer 7

Shampoos/sprays
Oral EFAs (steroid/ciclosporin sparing effect)
Topical lipid formulations if not already on EFAs

Question 8

Allergen avoidance and immunotherapy is part of treating CAD. What is the most important allergen source?

Answer 8

House dust mites

Question 9

Glucocorticoids are part of the treatment for CAD. What topical gluocorticoids can be used?

Answer 9

Betamethasone

Hydrocortisone

Question 10

Calcineurin inhibitors can be used topically or systemically for CAD. Name 1 topical and 1 systemic calcineurin inhibitor

Answer 10

Topical= tacrolimus ointment - not licensed, expensive
Systemic = ciclosporin - for chronic use, good with feet

Question 11

What are ADRs associated with calcineurin inhibitors (Tacrolimus, ciclospoirn)?

Answer 11

GI signs
Gingival hyperplasia
Viral papillomas
Hirsutism

Question 12

Oclacitinib (Apoquel) are daily Janus kinase tablets used for CAD. When are they contra-indicated?

Answer 12

If <1 year old
<3 kg
Or breeding dogs

Question 13

Lokivetmab (Cytopoint) is given subcutaneous monthly. Is it good for pruritis and inflammation?

Answer 13

Great for pruritis

Poor for inflammation

Question 14

Atopic flares are seen with secondary infections involving which pathoges?

Answer 14

Staph pyoderma
Malassezia dermatitis
Otitis

Question 15

What is atopic-like dermatitis?

Answer 15

Inflammatory and pruritic skin disease with NO detectable allergen specific IgE

Question 16

Is pruritis due to food induced atopic dermatitis responsive to steroids?

Answer 16

No

Question 17

What breeds are pre-disposed to food induced atopic dermatitis?

Answer 17

WHWT
Rhodesian ridgeback
Pugs
GSD

Question 18

How is food induced atopic dermatitis diagnosed?

Answer 18

Intradermal allergen testing
Histopath
(Food trials- not diagnostic - false positives/negatives)

Question 19

How long should a diet trial for food-induced atopy be conducted for? Should the diet be high in protein?

Answer 19

6-8 weeks minimum

Limited protein source - one not exposed to before

Question 20

Hydrolysed protein diets assume what type of hypersensitivity?

Answer 20

Type 1

Question 21

What should be given for the first 2 weeks whilst starting a hydrolysed protein diet?

Answer 21

Steroids - reduce secondary inflammation

vast majority improve in 1 week - if fails = ‘strict sense CAD’