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VET433: Dermatology > Atopic Dermatitis > Flashcards

Atopic Dermatitis Flashcards

1
Q

other names for atopic dermatitis in dogs and cats

A

dogs: environmental allergies

cats: non-flea, non-food hypersensitivity dermatitis (NFNFHD), feline atopic syndrome (FAS)

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2
Q

atopic dermatitis

A

inflammatory and pruritic skin disease

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3
Q

what causes atopic dermatitis

A

genetic predisposition to produce IgE antibodies to environmental allergens

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4
Q

how are environmental allergens absorbed to cause atopic dermatitis

A

percutaneously

NOT inhaled or ingested

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5
Q

is atopic dermatitis curable

A

no - lifelong

can severely impact quality of life

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6
Q

pathogenesis of atopic dermatitis

A

allergens breach the skin barrier –> type I hypersensitivity reaction –> IgE mediated release of antibodies –> mast cell degranulation

also caused by immune dysregulation (initial Th2 cytokine production –> chronically shifts to Th1, 2, 17, 22 –> tissue damage and fibrosis)

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7
Q

how do allergens breach the skin barrier

A

dogs with atopic dermatitis have large gaps in the skin barrier –> allergens/pathogens are able to adhere and penetrate into skin layer

also have a loss of microbiome diversity –> increased adhesion of staph to skin

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8
Q

signalment for atopic dermatitis

A

typically 1 to 3 years old

can range from 6 months to 6 years

breeds: retreivers, GSDs, terriers, bully breeds, sharpeis, setters, poodles

can affect ANY breed

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9
Q

clinical signs of atopic dermatitis in DOGS

A

highly variable
often starts as seasonal and progresses to non seasonal

  • severe pruritus
  • erythema
  • alopecia
  • excoriations + salivary staining
  • lichenification + hyperpigmentation
  • secondary infections
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10
Q

distribution of atopic dermatitis lesions in dogs

A

face - muzzle, periocular
ears
legs
paws
glabrous areas (axilla, inguinal area)

often secondary otitis externa + conjunctivitis

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11
Q

clinical signs of atopic dermatitis in CATS

A

non-specific signs and reaction patterns

  • marked facial pruritus
  • facial lesions
  • miliary dermatitis
  • overgrooming
  • bilaterally symmetric alopecia
  • eosinophilic dermatoses

often get chronic recurrent otitis externa and superficial pyoderma

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12
Q

eosinophilic dermatoses

A

eosinophilic reaction pattern

lesion in response to hypersensitivity reactions (NOT a diagnosis - seen with FAD and food allergies)

  • eosinophilic plaques
  • eosinophilic granulomas
  • indolent ulcers (lips)
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13
Q

how to diagnose atopic dermatitis

A

diagnosis of EXCLUSION

must first rule out:
- ectoparasites (fleas, FAD)
- bacterial and malassezia dermatitis
- dermatophytosis
- cutaneous adverse food reactions

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14
Q

can allergy testing be used to diagnose atopic dermatitis

A

NO - can only be used to support a previous diagnosis of atopic dermatitis

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15
Q

what are the types of allergy testing

A

serum and intradermal

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16
Q

when should allergy testing be performed

A
  • AFTER a diagnosis of atopic dermatitis is made
  • owner is interested in pursing allergen specific immunotherapy
  • owner is committed to 1 year of specific immunotherapy following testing
  • owner is aware that results will not be immediate
17
Q

what are the treatment options for atopic dermatitis

A
  1. allergen specific immunotherapy
  2. medical therapy (corticosteroids, apoquel, cytopoint, cyclosporine, zenralia)
  3. supplements/diet change
18
Q

allergen specific immunotherapy

A

allergen vaccines customized to a patient’s allergy testing results and known exposures in their environment

19
Q

how is ASIT performed

A

regular inoculations of small quantities of allergen either SQ or sublingually

20
Q

how does ASIT work

A

desensitizes the immune system by increasing Treg lymphocytes and IL-10 in response to the specific allergen affecting the patient

21
Q

ASIT efficacy

A

moderate
can take up to 9-12 months to see results

ONLY treatment that can induce long term change in the immune response

22
Q

what medical therapy is used for acute flare ups of AD

A

corticosteroids (prednisone)

23
Q

what medical therapy is used for chronic management of AD

A

cyclosporine A

24
Q

what medical therapy is used for acute flare ups AND chronic managemnet of AD

A

apoquel
cytopoint

25
Q

corticosteroids

A

broad anti-inflammatory - does NOT target dermatitis specifically

short term remedy for acute flare ups in severely affected dogs

highly efficacious but has signficant side effects (PU, PD, PP, cutaneous changes, drug reactions)

26
Q

apoquel (oclcitinib)

A

JAK inhibitor (JAK 1 and 3 pathways)

inhibits signaling cascade that releases pro-inflammatory and pruritogenic mediators (IL-31)

27
Q

efficacy, adverse effects, contraindications, and uses of apoquel

A

75% efficacy, rapid onset of action (4-6 hours)

adverse effects: mainly GI

contraindicated in puppies <1 year, dogs with neoplasia, deep pyoderma, or demodicosis

uses: acute flare ups and long term management
- manages ITCH not inflammation

labelled for use in dogs, can be used off-label in cats

28
Q

cytopoint (lokivetmab)

A

caninized monoclonal antibody that targets IL-31

reduces the quantity of circulating IL-31 and IL-31 receptors on nerve endings

29
Q

efficacy, adverse effects, contraindications, and uses of cytopoint

A

efficacy: 75% in dogs within 1-5 days

adverse effects: none

uses: acute flare ups and chronic management
- manages ITCH not inflammation

DOGS ONLY

30
Q

cyclosporine A (atopica, cyclavance)

A

calcineurin inhibitor

inhibits T cell synthesis of certain inflammatory and pruritogenic cytokines

31
Q

efficacy, adverse effects, contraindications, and uses of cytopoint

A

efficacy: 80% of dogs and cats

adverse effects: common - vomiting, diarrhea, inappetance

contraindications: pets with liver disease

uses: long term management
- manages inflammation + itch

32
Q

zenralia (iilunocitinib)

A

non-selective JAK inhibitor (JAK 1, 2, TYK2)

33
Q

efficacy, adverse effects, contraindications, and uses of zenralia

A

efficacy: 50% itch reduction after 7 days

adverse effects: anemia, leukopenia, elevated liver enzymes, GI upset, fatal vaccine induced disease
- MUST discontinue 1-3 months prior to receiving vaccinations and not give for 28 days after a vaccination

DOGS ONLY

VET433: Dermatology (5 decks)

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