Alternative clinical approaches to the treatment of pruritus related with canine atopic dermatitis

Abstract

Canine atopic dermatitis (CAD) is a genetically inheritable, inflammatory and pruritic skin disease with characteristic clinical features, most commonly associated with IgE antibodies to environmental allergens. Itching is the most prominent clinical finding. Depending on the allergens involved, seasonal or non-seasonal pruritus may occur. In the first active phase of pruritus treatment, which consists of two stages, acute exacerbations should be controlled by drugs with active ingredients such as corticosteroids, oclacitinib, lokivetmab, etc. In the proactive pruritus treatment, it is aimed to prevent exacerbations and prolong the pruritus-free period with maintenance treatment. For this purpose, in addition to active phase of the therapy, different treatment options such as cyclosporine, tacrolimus, antihistamines, essential fatty acids, Palmitoylethanolamide (PEA), topical drugs and shampoos can be used to repair the skin barrier. Due to the side effects and costs of the drugs used in the treatment of pruritus in atopic dermatitis, researches on alternative treatment methods are still continuing. Applications such as mesenchymal stem cell therapy, recombinant canine gamma-interferon, luteolin, vitamin D, vitamin E, lactoferricin/verbascoside, mastinib, cannabidiol (CBD), probiotics and vaccination against IL-31 are the alternative treatment options for atopic dermatitis in dogs. However, more studies are needed before their inclusion in our routine clinical practices and added to the guidelines. In this review, it is aimed to provide information about new treatments used for pruritus in CAD and to encourage their use in routine veterinary clinical practice.