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      Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification

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          Abstract

          Background

          Canine atopic dermatitis (AD) is a common, genetically predisposed, inflammatory and pruritic skin disease. The variation in clinical presentations, due to genetic factors, extent of the lesions, stage of the disease, secondary infections, as well as resemblance to other non-atopic related skin diseases, can complicate a diagnosis of canine AD. A sub-group of the International Committee for Allergic Diseases in Animals (ICADA) was tasked with the development of a set of practical guidelines that can be used to assist practitioners and researchers in the diagnosis of canine AD. Online citation databases and abstracts from international meetings were searched for publications related to the topic, and combined with expert opinion where necessary. The final set of guidelines was approved by the entire ICADA committee.

          Results

          A total of 81 publications relevant for this review were identified. The guidelines generated focus on three aspects of the diagnostic approach:

          1. Ruling out of other skin conditions with clinical signs resembling, or overlapping with canine AD.

          2. Detailed interpretation of the historical and clinical features of patients affected by canine AD.

          3. Allergy testing by intradermal versus allergen-specific IgE serum testing.

          Conclusions

          The diagnosis of canine AD is based on meeting clinical criteria and ruling out other possible causes with similar clinical signs. Flea combing, skin scraping and cytology should be performed, where necessary, as part of a thorough work-up. Elimination diet trials are required for patients with perennial pruritus and/or concurrent gastrointestinal signs. Once a clinical diagnosis of canine AD is made, allergy testing can be performed to identify potential causative allergens for allergen-specific immunotherapy.

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          Most cited references92

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          Prevalence of Bartonella henselae antibodies in pet cats throughout regions of North America.

          Cat exposure has been directly associated with the development of human Bartonella henselae infections, resulting in cat-scratch disease, bacillary angiomatosis, or bacteremia. The prevalence of serum antibody titers to B. henselae was determined for selected pet cats from 33 geographic locations throughout the United States and several areas in western Canada. Seroprevalences paralleled increasing climatic warmth (P < .02) and annual precipitation (P < .03). These warm, humid areas with the highest seroprevalence would also have the highest number of potential arthropod vectors. The southeastern United States, Hawaii, coastal California, the Pacific Northwest, and the south central plains had the highest average prevalences (54.6%, 47.4%, 40.0%, 34.3%, and 36.7%, respectively). Alaska, the Rocky Mountain-Great Plains region, and the Midwest had low average prevalences (5.0%, 3.7%, and 6.7%, respectively). Overall, 27.9% (175/628) of the cats tested were seropositive. The seroprevalence of B. henselae in cats varies throughout the United States and appears to be influenced by climate.
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            The ACVD task force on canine atopic dermatitis (XIV): clinical manifestations of canine atopic dermatitis.

            Canine atopic diseases, including those with skin lesions, have been described for many years. Unfortunately, early descriptions often failed to establish definitive guidelines for considering a patient atopic, and criteria for diagnosing atopic dermatitis (AD) have varied from author to author. Larger case-series published from the 1960s to the 1980s suggested that the most common clinical manifestation of AD was pruritus, particularly of the face, ears, paws, extremities, and/or ventrum. It is not always clear that testing to eliminate other differential diagnoses was always carefully performed on patients in early reports; therefore, some descriptions could include patients affected with diseases other than or in addition to AD. Points of consensus regarding clinical manifestations of AD in case-series include the presence of pruritus beginning at a young age, possibly seasonally; and a prominent lesional involvement of the face, extremities, axillae or ventrum. Conflicting information on breed and sex predispositions is present, perhaps representing regional or temporal variability. Clinical reports vary, in regard to the description of lesions seen in dogs with AD. This reflects a possible confusion with lesions of secondary complications, and highlights the fact that the existence and nature of primary lesions of canine AD are not truly known.
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              Revised nomenclature for veterinary allergy.

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                Author and article information

                Contributors
                phensel@tierdermatologie.ch
                dsantoro@ufl.edu
                cfavrot@vetclinics.uzh.ch
                p.hill@adelaide.edu.au
                skinvet44@aol.com
                Journal
                BMC Vet Res
                BMC Vet. Res
                BMC Veterinary Research
                BioMed Central (London )
                1746-6148
                11 August 2015
                11 August 2015
                2015
                : 11
                : 196
                Affiliations
                [ ]Tierdermatologie Basel, Emil Frey-Strasse 127, Münchenstein, Switzerland
                [ ]Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL USA
                [ ]Vetsuisse Faculty University of Zurich, Clinic of Small Animal Internal Medicine, Zurich, Switzerland
                [ ]Companion Animal Health Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, SA 5371 Australia
                [ ]Animal Dermatology Clinic, San Diego, CA USA
                Article
                515
                10.1186/s12917-015-0515-5
                4531508
                26260508
                cbf3b743-a01b-44e1-ab58-65588957630f
                © Hensel et al. 2015

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 July 2015
                : 30 July 2015
                Categories
                Correspondence
                Custom metadata
                © The Author(s) 2015

                Veterinary medicine
                Veterinary medicine

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