Update on canine atopic dermatitis

Abstract

Canine atopic dermatitis is a hereditary, generally pruritic and predominantly T-cell driven inflammatory skin disease involving interplay between skin barrier abnormalities, allergen sensitisation and microbial dysbiosis. Canine atopic dermatitis is a pruritic disease, which most often appears at 1–3 years of age, commonly affecting body areas such as ears, axillae, inguinal area and feet. The chronic nature of canine atopic dermatitis means it also has a significant impact on the dog's quality of life. The diagnosis of canine atopic dermatitis is based on clinical presentation and exclusion of other diseases with a similar clinical presentation, such as ectoparasitic infestations, microbial skin infections and food allergies. Allergy testing, eg by intradermal testing or allergen-specific IgE serology testing, is a useful tool to identify the responsible allergens for inclusion in allergen-specific immunotherapy. However, allergy testing should not be used as a diagnostic tool. Depending on the severity of the disease and expectations of owners, a combination of controlling flare factors (eg, strict flea prevention, diet limitation), symptomatic treatments (eg glucocorticoids, ciclosporin, oclacitinib, ilunocitinib, atinvicitinib, lokivetmab), and allergen-targeted interventions (eg allergen-specific immunotherapy, allergen avoidance) is recommended. Most dogs will require lifelong therapy and the management of atopic dermatitis will require regular adjustments.