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20- SA- Dermatology > Allergic skin disease > Flashcards

Allergic skin disease Flashcards

1
Q

List 3 common triggers for allergic skin disease

A

environmental allergens
Foods
ectoparasites

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2
Q

what hypersensitivity is most commonly involved with allergic skin disease

A

type 1- immediate - IgE

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3
Q

Define canine atopic dermatitis

A

A common chronic, relapsing, pruritic and inflammatory skin syndrome with characteristic clinical features- broken down into environmental and food- triggered

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4
Q

List 3 factors needed for environmental canine atopic dermatisis

A

defective cutaneous barrier function
microbial dysbiosis/ overgrowth/ infection
hypersensitivity reaction

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5
Q

List 2 things targeted in some canine atopic dermatitis treatments

A

IL31
Janus kinase pathways

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6
Q

what are the pathognomonic signs for canine atopic dermatitis

A

there are none

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7
Q

If you see crusty ear margins what is it likely to be

A

sarcoptic mange

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8
Q

Describe the history typically seen with canine atopic dermatitis

A

nearly always pruritic
scratch, lick, rub, scoot
onset usually 6m-3 yr
may start seasonally –> year round
most will respond to anti-inflammatory dose of corticosteroids

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9
Q

what age does food-triggered atopic dermatitis generally start

A

can develop at any age
30-50% start at <1yr
More likely than environmental CAD if onset <6mo?
Sensitisation not associated with diet change!

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10
Q

List the clinical signs of food-triggered allergic atopic dermatitis

A

Skin signs clinically indistinguishable from environmental CAD

+/- Concurrent clinical signs, e.g.
- GI signs
- Urticaria/angioedema
- Malassezia dermatitis

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11
Q

Describe feline atopic syndrome

A

can manifest in skin, GI tract or resp tract

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12
Q

Describe Feline atopic skin syndrome (FASS)

A

Inflammatory/pruritic skin syndrome, likely associated with IgE to environmental allergens
Usually young adult – 6mo-5y onset (occasionally older)
Seasonal/ non-seasonal
most commonly presents with one of the 4 reaction patterns

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13
Q

Describe Feline food allergy (FFA)

A

can occur at any age from 3 months onwards
Non-seasonal
+/- GI/conjunctivitis/respiratory signs
most commonly presents with one of the 4 reaction patterns

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14
Q

How common is contact hypersensitivity

A

very uncommon

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15
Q

what does contact hypersensitivity need to be differentiated from

A

contact irritant dermatitis

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16
Q

Describe how contact hypersensitivity present

A

Sensitisation usually over prolonged period
Lesions in areas of contact only!
Particularly affects sparsely haired regions

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17
Q

Describe how to diagnose contact hypersensitivity

A

patch test- rarely performed

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18
Q

Describe eosinophilic folliculitis/ furunculosis

A

Reaction to presumed arthropod bite
Acute onset, highly pruritic
Often affects dorsal muzzle +/- other sites

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19
Q

List the 3 I’s we are trying to control in atopic dermatitis

A

Inflammation
Itch
Infection

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20
Q

List 4 things we need to balance when treating atopic dermatitis

A

Product efficacy/ speed of onset`
Risk side effects
Treatment feasibility/ owner compliance
Cost

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21
Q

how does oclacitinib target

A

JAK inhibitor

22
Q

what does lokivetmab target

A

IL-31 monoclonal antibody- only affects pruritus not inflammation

23
Q

Describe action of glucocorticoids to treat pruritus

A

highly effective re inflammation and pruritus, rapid onset (24h), inexpensive – but significant risk of side effects, esp with long term use

24
Q

List 3 things we aim for when using glucocorticoids to treat pruritus

A

aim to use:
lowest potency product
lowest dose
shortest time

that will be effective

25
Q

describe the effects of oclacitinib

A

Excellent antipruritic, some anti-inflammatory effect
NB for treatment of allergic pruritus and dermatitis only,

26
Q

Descrieb the effects of lokivetmab

A

Excellent antipruritic but minimal anti-inflammatory effect

27
Q

Describe the effects of ciclosporin

A

Excellent anti-inflammatory and antipruritic

takes 1-2 months to work

28
Q

List 3 ways to improve the skin barrier

A

topical moisturisers
systemic essential fatty aids
essential oils

29
Q

List 3 ways to control flare factors

A

Good ectoparasite control
Avoid overheating
Control microbial populations –e.g. antimicrobial shampoos/wipes/foams

30
Q

which products are licensed for atopic dermatitis in cats

A

GCCs and ciclosporin

31
Q

An 11yo patient that is on oclacitinib for control of canine atopic dermatitis is diagnosed with renal failure. What would be the safest option for ongoing control of his skin condition?

A

Change to lokivetmab

32
Q

List 3 common environmental CAD allergens

A

dust mites
pollens
moulds

33
Q

What pathway is used to activate and proliferate inflammatory cells

A

Janus Kinase (JAK) pathways

34
Q

Describe what happens when there is chronic scratching

A

activated keratinocytes adn other immune cells

increased monocyte/macrophage recruitment and activation

thickening of the epidermis/stratum corneum

35
Q

List 3 types of adverse food reactions

A

food allergy
food intolerance
intoxication

36
Q

when do the majority of food allergies develop

A

when the animal is older than 1

37
Q

what is the most common cause of cutaneous reaction patterns of cats

A

feline atopic skin syndrome
feline food allergy
feline allergy dermatitis

38
Q

Describe how to diagnose FASS - feline atopic skin syndrome

A

eliminate ectoparasites and bacterial/fungal infections

do a diet exclusion trial to rule out FFA

39
Q

Describe how to diagnose FFA- feline food allergy

A

diet exclusion trial

40
Q

are allergy tests of value for diagnosis of canine atopic dermatitis

A

No

41
Q

List 4 options for anti-pruritics

A

glucocorticoids
ciclosporin
oclacitinib
lokivetmab

42
Q

what is a problem with depo injection of systemic glucocorticoids

A

diabetogenic and risk HPA axis suppression

43
Q

how often do we want to give oral glucocorticoids and why

A

we want the lowest effective alternate day dose, so that we can prevent HPA axis suppression

44
Q

what are the risks of long term glucocorticoid topical application

A

systemic absorption and skin thinning

45
Q

can we put hydrocortisone aceponate spray on broken skin

A

No

46
Q

how old do animals need to be in order to have oclacitinib

A

1 year old minimum

47
Q

how often do we give lokivetmab

A

every 4 weeks

48
Q

how does ciclosporin cause anti-pruritic effects

A

T-cell suppressor

49
Q

can antihistamines be used in animals

A

yes but they are unlicensed

50
Q

what can allergen-specific immunotherapies be made against

A

environmental allergens or Malassezia

51
Q

how long do you have to wait to see if allergen therapy has worked

A

trial for 12 months

52
Q

what are the 2 phases of atopy treatment

A

reactive - initial rapid control

proactive - ongoing maintenance therapy to prevent recurrence

20- SA- Dermatology (21 decks)

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