Atopic Dermatitis in Dogs Quiz

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Questions and Answers

Which medication should not be used as a sedative due to its potential interference with testing?

  • Ibuprofen
  • Acetaminophen
  • Naproxen
  • Ketamine (correct)

What is the standard withdrawal time for antihistamines before testing?

  • 14 days
  • 3 days
  • 7 days (correct)
  • 28 days

What should be adjusted to manage an acute flare-up in a dog with atopic dermatitis?

  • The treatment regime (correct)
  • The patient's diet
  • The exercise routine
  • The duration of the treatment

How long should parenteral glucocorticoids be withdrawn before testing?

<p>28 days (C)</p> Signup and view all the answers

Which of the following is NOT a component of managing atopic dermatitis in dogs?

<p>Psychological counseling (A)</p> Signup and view all the answers

What is a primary characteristic of atopic dermatitis as defined in the content?

<p>It is a pruritic allergic skin disease associated with IgE. (C)</p> Signup and view all the answers

Which of the following is a common environmental allergen associated with atopic dermatitis?

<p>House dust mites (A)</p> Signup and view all the answers

What percentage of dogs with adverse food reactions also have concurrent environmental allergies?

<p>20-30% (B)</p> Signup and view all the answers

Which factor is NOT associated with the pathogenesis of atopic dermatitis?

<p>High-fat diet consumption (A)</p> Signup and view all the answers

What is the main goal when diagnosing atopic dermatitis?

<p>To rule out all other skin conditions (D)</p> Signup and view all the answers

What is a characteristic feature of atopic-like dermatitis?

<p>Clinical features identical to canine atopic dermatitis (B)</p> Signup and view all the answers

Which breeds are predisposed to atopic dermatitis?

<p>West Highland White Terrier, Shar-pei (C)</p> Signup and view all the answers

What is the age of onset for atopic dermatitis in dogs?

<p>5 months to 5 years (C)</p> Signup and view all the answers

What distinguishes feline allergic skin disease (FASD) from atopic dermatitis?

<p>The role of IgE is uncertain (B)</p> Signup and view all the answers

Which external stimuli can exacerbate cutaneous inflammation in cats?

<p>Flea saliva and insect bites (A)</p> Signup and view all the answers

What is a primary challenge in understanding the pathogenesis of atopic dermatitis?

<p>Its multifactorial nature complicates understanding (B)</p> Signup and view all the answers

Which of the following options is an important historical aspect to consider when evaluating a dog for skin issues?

<p>Diet history and environmental exposure (B)</p> Signup and view all the answers

Which statement regarding atopic-like dermatitis is accurate?

<p>It mirrors the symptoms of atopic dermatitis without IgE involvement (A)</p> Signup and view all the answers

What criteria must be satisfied to achieve an 85% sensitivity in diagnosing atopic dermatitis?

<p>Satisfy 5 criteria (D)</p> Signup and view all the answers

What is a key diagnostic method to rule out ectoparasites?

<p>Coat brushing for flea dirt (B)</p> Signup and view all the answers

Which condition is indicated by papulopustular eruptions and epidermal collarattes?

<p>Pyoderma (A)</p> Signup and view all the answers

What finding would suggest atopic dermatitis rather than a secondary infection?

<p>Glucocorticoid responsive pruritus (D)</p> Signup and view all the answers

What is the main reason to rule out secondary infections in pruritic patients?

<p>They can complicate the diagnosis (A)</p> Signup and view all the answers

Which diagnostic tool is not typically used for ruling out infections?

<p>MRI scan (A)</p> Signup and view all the answers

Which IgG serology is indicated for ruling out specific ectoparasites?

<p>Sarcoptes (C)</p> Signup and view all the answers

What is an indication that a dog may be suffering from atopic dermatitis?

<p>Alesional pruritus at onset (B)</p> Signup and view all the answers

What condition is characterized by erythema and lichenification of the ear canal in allergic dogs?

<p>Otitis (A)</p> Signup and view all the answers

Which breed is commonly affected by lesions on the eyelids and flexor surfaces of joints?

<p>French Bulldog (A)</p> Signup and view all the answers

What secondary condition is characterized by alopecic, erythematous lesions often found on the ventral neck of allergic dogs?

<p>Malassezia dermatitis (C)</p> Signup and view all the answers

Which of the following describes a common finding of atopy in dogs?

<p>Pododermatitis with alopecia (B)</p> Signup and view all the answers

What is a potential consequence of severe pruritus leading to self-mutilation of the feet in dogs?

<p>Pododermatitis (A)</p> Signup and view all the answers

Identify a differential diagnosis that falls under allergies or autoimmune conditions in dogs.

<p>Flea allergy (C)</p> Signup and view all the answers

What condition can be differentiated from atopic dermatitis via diagnostic investigation?

<p>Malassezia dermatitis (D)</p> Signup and view all the answers

Which condition is most likely to present with pododermatitis in dogs?

<p>Atopic dermatitis (A)</p> Signup and view all the answers

What is an important consideration when managing flare factors in atopic dermatitis?

<p>Parasite control (A)</p> Signup and view all the answers

How should topical glucocorticoids be administered for flare-ups in atopic dermatitis?

<p>SID for 1-2 weeks (C)</p> Signup and view all the answers

What are emollient shampoos primarily used for in skin and coat care?

<p>To moisturize and soothe the skin (C)</p> Signup and view all the answers

Which medication is specifically recommended for Malassezia management during flare-ups?

<p>Itraconazole (D)</p> Signup and view all the answers

How are allergens typically avoided in managing atopic dermatitis?

<p>By using allergen-specific immunotherapy (D)</p> Signup and view all the answers

Which of the following is NOT a recommended strategy for managing chronic atopic dermatitis?

<p>Avoiding all forms of allergens (C)</p> Signup and view all the answers

What is the typical dosing for oral glucocorticoids in managing flare-ups?

<p>0.5-1 mg/kg SID/BID then taper (C)</p> Signup and view all the answers

What is a required condition for allergen-specific immunotherapy?

<p>It requires a special import certificate (B)</p> Signup and view all the answers

Which of the following is a component of skin and coat care for chronic atopic dermatitis?

<p>Weekly bathing with emollient shampoos (C)</p> Signup and view all the answers

What is a primary focus of allergen-specific management?

<p>Identifying and avoiding known allergens (C)</p> Signup and view all the answers

Flashcards

What is atopic dermatitis?

Atopic dermatitis (AD) is a common skin allergy in dogs, caused by an overreaction to environmental allergens. This hypersensitivity is triggered by IgE antibodies, resulting in itchy, inflamed skin.

What are the key triggers for atopic dermatitis?

Atopic dermatitis is triggered by environmental allergens, commonly house dust mites, grass pollen, and other airborne substances. These allergens bind to IgE antibodies on mast cells, leading to the release of inflammatory chemicals that cause itchiness and skin irritation.

What are the typical clinical signs of atopic dermatitis?

Atopic dermatitis often manifests with intense itching, leading to scratching, licking, and chewing. This can result in red, inflamed skin, hair loss, and skin infections.

How is atopic dermatitis diagnosed?

Diagnosing atopic dermatitis involves a combination of clinical history (itching, age of onset), physical examination, and allergy testing. Blood tests and skin biopsies can help identify specific allergens and rule out other skin conditions.

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How is atopic dermatitis managed?

Management of atopic dermatitis aims to control itchiness and prevent flare-ups. This involves environmental control (reducing exposure to allergens), targeted medications (anti-inflammatory, antihistamines), and allergen-specific immunotherapy.

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Atopic-Like Dermatitis

A skin condition in dogs where the symptoms are identical to Atopic Dermatitis but without a detectable IgE response to allergens. It is an inflammatory and itchy skin condition.

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Canine Atopic Dermatitis

A complex condition in dogs that involves a combination of a weakened skin barrier and allergic reactions. It often results in itchy skin and inflammation.

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Pathogenesis of Atopic Dermatitis

A condition in dogs where the exact cause is unknown and likely involves a combination of genetic predisposition and environmental factors. It often involves a weakened skin barrier and may involve an allergic component.

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Breed Predisposition for Atopic Dermatitis

Dogs that are more likely to develop Atopic Dermatitis. This is a genetic factor, but no single gene is responsible for the condition.

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Age of Onset for Atopic Dermatitis

A range of ages when dogs are most likely to develop Atopic Dermatitis.

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Feline Allergic Skin Disease (FASD)

A skin condition in cats, similar to Atopic Dermatitis in dogs, but the role of IgE is unclear. It is an inflammatory and itchy skin condition.

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Pathogenesis of Feline Allergic Skin Disease (FASD)

A condition in cats caused by a complex interaction of genetics and environmental factors. It is often triggered by flea saliva, food and environmental allergens.

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Taking History for Skin Conditions

Gathering information about a pet's history to help diagnose and manage skin conditions. This includes general history, medical history, dermatological history, diet, environment and contact information.

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Interfering medications with skin allergy testing

Certain medications can interfere with a dog's skin allergy testing. The medications to be aware of are antihistamines, glucocorticoids, progesterone products, tricyclic antidepressants and bronchodilators.

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Acute flare-up in atopic dermatitis

A temporary worsening of atopic dermatitis in dogs, brought on by increased exposure to an allergen. This usually results in the dog reaching their 'pruritic threshold'.

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Managing flare-up factors

Addressing factors that worsen atopic dermatitis. These factors might include skin and coat care, managing specific allergens, and appropriate medications.

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Chronic atopic dermatitis

A persistent and ongoing state of atopic dermatitis in dogs. Careful management is needed to maintain long-term control of the condition.

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Pharmacotherapy in atopic dermatitis

Using medications to manage atopic dermatitis. This may involve short-term treatments to control flare-ups and long-term maintenance therapies.

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Pododermatitis

A skin condition that causes inflammation, hair loss, and redness between the toes and the central pad of the paw. It is a common sign of atopy in dogs.

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Otitis

A common finding in allergic dogs, it can be a severe, itchy condition that affects the ear canal. It often leads to secondary yeast infections.

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Malassezia Dermatitis

This skin condition is caused by an overgrowth of the yeast Malassezia, often triggered by an underlying allergy. It's characterized by hair loss, redness, and thickened skin, particularly on the neck and ventral areas.

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Breed Specific Lesion Distribution

Atopical Dermatitis (AD) can have different patterns of skin lesions depending on the breed. French Bulldogs, German Shepherds, Shar Peis, and Boxers have distinctive areas of affected skin. This distribution pattern is a key to recognizing breed-specific variations in AD.

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Pruritus

Intense itching can be a symptom of various skin conditions in dogs. Common culprits include parasites like fleas, harvest mites, and sarcoptic mange, allergic conditions like atopy and contact allergies, infections like bacterial pyoderma and ringworm, and even neoplastic or neurological conditions like cutaneous lymphoma or acral lick dermatitis. This list highlights the importance of careful diagnosis to determine the underlying cause of the itching.

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Diagnosing Atopic Dermatitis

Diagnosing atopy requires a thorough evaluation. The first step is a complete examination and history. It's key to rule out other common skin conditions.

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Diagnostic Investigation

The goal of diagnosing Atopic Dermatitis (AD) is to identify the cause of the dog's itching and hair loss. It is crucial to consider the breed, the distribution of skin lesions, and the presence of secondary infections or allergies. Once the cause is understood, the appropriate treatment plan can be established.

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Atopic Dermatitis

Atopic dermatitis is a chronic inflammatory skin disease that affects dogs. It's caused by allergies to environmental allergens like pollen, dust mites, and mold. It leads to intense itching, skin redness, and hair loss. The condition is typically diagnosed based on symptoms, breed, and allergic testing. Atopic dermatitis is more prevalent in certain breeds, including Labrador Retrievers, Golden Retrievers, and West Highland White Terriers.

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Topical Management of Atopic Dermatitis

Applying medications directly to the skin, such as antibiotics or anti-fungal agents, to reduce inflammation and treat infections during acute flare-ups.

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Systemic Management of Atopic Dermatitis

Using medications given by mouth or injection to treat infections or inflammation during acute flare-ups.

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Emollient Shampoos

Specialized shampoos containing ingredients like lipids and complex sugars that help to moisturize and soothe the skin, reducing dryness and irritation.

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Allergen Avoidance

Reducing exposure to known allergens that trigger allergic reactions in a dog with atopic dermatitis.

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Itraconazole

A medication used to treat Malassezia yeast infections, often associated with atopic dermatitis.

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Pharmacotherapy for Atopic Dermatitis

Using medications that suppress the immune system to reduce inflammation and itching in atopic dermatitis.

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Topical Glucocorticoids

A type of corticosteroids applied to the skin to quickly reduce inflammation and itching during acute flare-ups.

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Oral Glucocorticoids

A type of corticosteroids given by mouth to reduce inflammation and itching, especially during severe flare-ups.

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Oclacitinib

A medication used to treat atopic dermatitis by blocking a specific type of immune system signaling that causes inflammation.

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Allergen Specific Immunotherapy

A long-term treatment for atopic dermatitis that involves gradually exposing the dog to specific allergens to desensitize the immune system.

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What are common features of Atopic Dermatitis in dogs?

Atopic dermatitis is a common skin condition in dogs that typically begins before the age of 3. It is characterized by intense itching, often affecting the front feet, ear pinna, and other areas. Atopic dermatitis is often diagnosed based on its symptoms and clinical presentation, but diagnosis can be challenging as other skin conditions can mimic its characteristics.

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What diagnostic criteria are used to identify Atopic Dermatitis in dogs?

These criteria can be used to aid in the diagnosis of atopic dermatitis in dogs. They include factors like age, areas affected, and response to treatment. However, it's important to note that even when these criteria are met, there is a chance of misdiagnosis.

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Why is it important to consider alternative diagnoses before diagnosing atopic dermatitis?

Before diagnosing atopic dermatitis, it is essential to rule out other common causes of skin problems in dogs, especially those that are easily treatable. This includes ectoparasites (like fleas and mites) and skin infections. Treatments for these conditions can often resolve itching and skin irritation.

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What are ectoparasites, and why are they important to consider in diagnosing atopic dermatitis?

Ectoparasites are external parasites that live on the skin of dogs and can cause intense itching and skin irritation. Common examples include fleas, mites, and ticks. It's important to look for evidence of ectoparasites such as flea dirt, mites in skin scrapings, or hair abnormalities.

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Why must skin infections be ruled out before diagnosing atopic dermatitis?

Skin infections can be easily treated and must be ruled out to ensure proper diagnosis of atopic dermatitis. They can be caused by bacteria, yeast, or other organisms. These infections can cause inflammation, pus, and skin irritation. The identification of these infections requires microscopic examination of skin samples from the affected areas.

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What is cytology, and how is it used in diagnosing skin conditions?

Cytology is a technique where a sample from the skin is examined under a microscope to identify bacteria, yeast, or fungal organisms. The results are then analyzed to determine the cause of the skin infection. This technique is essential for ruling out infections before diagnosing atopic dermatitis.

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Why is it important to consider skin infections caused by Staphylococcus pseudointermedius in diagnosing atopic dermatitis?

Staphylococcus pseudointermedius is a common bacteria that causes skin infections in dogs. It can be found on the skin of healthy dogs, but it can also cause problems when it grows in excess. S. pseudointermedius often causes papulopustular eruptions and epidermal collarrettes, which are common signs of pyoderma. It is important to identify and treat these infections before diagnosing atopic dermatitis.

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What is Malassezia dermatitis, and how is it related to atopic dermatitis?

Malassezia dermatitis is a common complication of atopic dermatitis. It is caused by an overgrowth of the Malassezia yeast organism. It often affects areas of the skin with folds like the armpits and groin. It can be identified with cytology. Infections caused by Malassezia must be addressed before diagnosing atopic dermatitis.

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Study Notes

Atopic Dermatitis in Dogs

  • Atopic dermatitis (AD) is a genetically predisposed, inflammatory, and pruritic allergic skin disease, characterized by clinical features often linked to IgE responses, mainly against environmental allergens.
  • The pathogenesis of AD is complex and multifactorial, involving interactions between the host and the environment, often linked to an epidermal lipid barrier defect and IgE-mediated hypersensitivity.
  • A similar condition in dogs is called Atopic-Like Dermatitis. This condition presents clinically similar to Atopic Dermatitis but lacks a measurable IgE response to environmental allergens.
  • 20-30% of dogs with adverse food reactions also exhibit environmental allergies.

Learning Objectives

  • Define atopic dermatitis.
  • Identify the pathogenesis, causes, and clinical signs of atopic dermatitis.
  • Describe diagnostic procedures for atopic dermatitis.
  • Discuss approaches to treatment and management of atopic dermatitis.

Causes of Allergic Skin Disease in Dogs

  • Atopic dermatitis
  • Flea allergy dermatitis
  • Food allergy

What is Atopic Dermatitis (AD)?

  • A genetically predisposed, inflammatory, pruritic allergic skin disease with clinical features, primarily due to IgE-mediated reactions against environmental allergens.
  • Key clinical features include impaired barrier function and IgE-mediated hypersensitivity.
  • Approximately 80% of affected dogs have specific IgE to house dust mites, grasses, and other similar allergens.

Clinical Signs of Atopic Dermatitis

  • Pruritus (itching)
  • Erythema (redness)
  • Saliva staining
  • Recurrent otitis (ear infections)
  • Pyoderma (bacterial skin infections)
  • Pododermatitis (footpad inflammation)
  • Malassezia dermatitis (yeast infection)
  • Excoriation (scratching-induced skin damage), lichenification, and alopecia (hair loss).

Lesion Distribution

  • Breed-specific variations exist in lesion distribution.
    • French Bulldogs often exhibit lesions on their eyelids and joints.
    • German Shepherds (GSD) often have lesions on their elbows, hind limbs, and thorax.
    • Shar-Peis frequently have issues in their thorax and dorsolumbar areas.
    • Boxers tend to show lesions on their ears.

Differential Diagnoses

  • Parasites (fleas, mites, etc.)
  • Allergies (food, contact, etc.)
  • Infections (bacterial, fungal, etc.)
  • Neoplastic/neurogenic conditions
  • Dermatological conditions

Diagnostic Investigations

  • History and clinical signs to indicate the possible diagnosis of Atopic Dermatitis.
  • Exclude ectoparasites, infections, and food allergies.

Atopic Dermatitis Diagnostic Criteria

  • Onset before 3 years of age
  • Mostly indoor lifestyle
  • Glucocorticoid-responsive pruritus
  • Pruritus evident at the start of the disease
  • Front feet are affected
  • Ear pinna inflamed
  • Dorsolumbar area unaffected
  • There is a 20% misdiagnosis rate using these criteria.

Rule out Ectoparasites

  • Coat brushing
  • Hair plucks
  • Skin scrapes
  • Sarcoptes IgG serology
  • Otoscopic examination
  • Trial treatment

Rule out Infections

  • Pyoderma (Staphylococcus pseudointermedius)
  • Malassezia dermatitis
  • Cytology (tape strip, impression smear, and ear cytology)

Rule out Food Allergies

  • Diet trial (novel protein and carbohydrate source for 6-8 weeks)
  • Reintroduction of the original food and observation for relapse.

Treatment of Atopic Dermatitis

  • Manage flare-up factors: addressing triggers and topical/systemic antibiotics; Itching management.
  • Skin and coat care: Regular bathing with emollient shampoos (containing lipids or complex sugars or antiseptics); Important to maintain coat/skin health.
  • Allergen-specific management: Avoidance of allergens if possible (removing problematic litter sources or restricting exposure during walks).
  • Pharmacotherapy: Using corticosteroids; if a flare-up happens, you can use short term corticosteroids.
  • Biological therapies: For chronic conditions, look at injections every 4-8 weeks.

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