What is atopic dermatitis ?

Canine Atopic Dermatitis (CAD) is an allergic inflammatory and itchy skin disease.
It is triggered by environmental substances (allergens) such as grass or tree pollens , dust mites, molds.
In recent years CAD has substantially increased its diffusion as well as in humans (especially in children, while in adults are prevailing respiratory diseases like allergic rhinitis and asthma).
In cats scientific knowledge is less precise but certainly there is a similar allergic disease (see factsheet "The cat is not a small dog").
In dogs there is a hereditary predisposition and some breeds are more affected than others.

Generally it begins to occur between 6 months and 3 years of age and continues throughout life.
Depending on the allergen involved, the disease may be seasonal (eg. pollens) or persistent during the year (eg. dust mites). It often begins as seasonal and gradually becomes annual.

The dominant symptom (often the only) is pruritus with subsequent skin lesions.
Other possible symptoms are: sneezing, chronic conjunctivitis, rhinitis, sweating, presence of small papules or wheals.  The most typical areas of itching in dogs are the face (eyes, lips, ears), feet, groin and axillas.
The skin, traumatized by chronic scratching\licking , is often reddened and alopecic or hyperpigmented and thickened and frequently undergoes secondary complications (bacterial, Malassezia dermatitis, seborrhea, recurrent ear infections).

The diagnosis is made by the Veterinary surgeon  on the basis of symptoms described by the owner and the clinical examination of the animal.

There are at least two other diseases (food allergic dermatitis and scabies) presenting  very similar clinical symptoms  and that should be excluded in order to achieve the correct diagnosis.
Allergy testings (see factsheet) instead are used to know what the animal is allergic to.

THERAPY
Once made the diagnosis of atopic dermatitis and identified responsible allergens (ie substances to which the animal is allergic), we need to choose the best treatment, taking into account that it is a chronic disease that most likely affect the animal throughout life.
Depending on the severity of the disease and on the attention paid by the pet owner, it can be expected from the therapy best (disappearance of itching) or partial (reduction in the intensity and\or the duration of itching) results.

It 's very important for the therapy success that the pet owner does not "discourage" in front of recurrences but talk about it with his veterinarian, without interrupting treatment.
Atopic Dermatitis requires a personalized therapy and flexible adjustments, drug associations etc.  There is no treatment that works for all animals, and in all moments.
Keeping a diary by the owner is very helpful for the veterinarian and the dermatologist to improve therapy.

We can choose (and associate) among three therapeutic indications:
 

• Elimination of allergen from the environment: this is the optimal solution but is achievable only in a few cases, or partially (see factsheet).

• Immunotherapy: so-called "vaccine". It's the only treatment acting directly on the causes of allergies and as such is highly recommended in young or adult animals and in cases of persistent itching during the year.

       The efficacy is estimated in 60-70% of the cases (see factsheet).

• Medical therapy :  is based on the use of drugs and other side therapies  (nutritional supplements, shampootherapy etc.).

There are effective drugs, such as corticosteroids, that are not suitable for long-term administration due to their  side effects. They will therefore be used to control pruritus for short periods.
Other drugs, with rare side effects, may instead be continued for long periods, more or less associated with each other and with other treatments.
Any complicating infections are cured with local (shampoos, solutions, creams, etc.) or general (antibiotics, antifungals) treatments.
In any case, the profilaxis for fleas must be done regularly.