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Atopic Dermatitis
Atopic dermatitis (Atopy), an allergic skin syndrome in dogs and rare in cats is characterized by itcy and inflammed skin and ranks second in skin problems to flea allergies.

Atopic dermatitis seems prevalent in dogs the way feline herpes seems prevalent in cats with a suggested weakened immune system. One wonders if early on one gives a puppy extra immune support such as olive leaf, astralagus, ester C, flaxseed oil, fish oil, etc, there might less incidents of atopic dermatitis. One also wonders if topic ointments such as Emu oil might help outbreaks of atopic dermatitis.

An interesting study on pregnant women whose babies had forty percent less incidence of atopic eczema than the children in the placebo group The women took supplements of Lactobacillus rhamnosus GG shortly before childbirth. This study shows how important stimulating the immune system is and how confusing it is to discriminate between genetics(or breeding practices) and the immune system. I haven't found studies but they might exist correlations with breeding practices.

The most common breeds affected by atopic dermatitis are Boston terrier, boxer, Cairn terrier, Chinese shar-pei, dalmatian, English setter, golden retriever, Irish setter, Labrador retriever, Lhasa apso, miniature schnauzer, pug, Scottish terrier, West Highland White terrier, and wire-haired fox terrier.
The face, paws, lower legs, groin are usually the areas effected. Atopic dermatitis usually shows up in the first to third year but can appear later. (Humans as they get older and their immune systems weakened also can get atopic dermatitis). Dogs with atopy are also prone to recurrent to skin and ear bacterial and yeast infections which also have to be treated.

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ATOPIC DERMATITIS IN THE DOG
excellent article with mention of treatment options such as essential fatty acids and "Antihistamines potentiate the action of essential fatty acids (synergy) and so combination therapy would appear to be valuable. ....Antihistamines were widely dismissed as unhelpful in atopic disease until recently when new studies both in the US and UK have shown considerable benefits from their use. No veterinary products are available and the human drugs, chlorpheniramine, hydroxyine, and clemastine have all shown to be useful."
excerpt from alternative health re atopic dermatitis
HOW IMPORTANT IS IMMUNOGLOBULINE IN CANINE ATOPIC DERMATITIS
Long Term Management of Canine Atopic Dermatitis
Vet Dermatol. 2004 Jun;15(3):137-45. : A randomized, controlled study to evaluate the steroid sparing effect of essential fatty acid supplementation in the treatment of canine atopic dermatitis.
Saevik BK, Bergvall K, Holm BR, Saijonmaa-Koulumies LE, Hedhammar A, Larsen S, Kristensen F.
Department of Small Animal Clinical Sciences, The Norwegian School of Veterinary Science, PO Box 8146, Dep., N-0033 Oslo, Norway.
bente.k.saevik@veths.no

A randomized, double blind, placebo-controlled multicentre clinical trial of 12 weeks' duration was undertaken in 60 dogs with atopic dermatitis to evaluate the steroid sparing effect of essential fatty acid supplementation. The dogs were randomly assigned to receive either a combination of borage seed oil and fish oil or a placebo, in addition to prednisolone tablets. All dogs received a standardized basal diet. Owners of the dogs recorded pruritus daily using a 10 cm visual analog scale and the dosage of prednisolone was established based on the pruritus score, according to written instructions. The dosage of prednisolone and the use of any concurrent treatment (shampoo and/or ear-cleanser) were recorded by the owner on a daily basis. The investigators graded the skin lesions at days 0, 42 and 84. The use of prednisolone during the test period was lower in the active group, but the difference was not statistically significant (P = 0.32). The test period was sequentially divided into 43-84, 50-84, 57-84, 64-84, 71-84 and 78-84 days. On day 64, the difference between the active group and the placebo group reached statistical significance (P = 0.04) with an increasing difference towards the end of the study. A statistically significant reduction in the pruritus scores and the total clinical scores from day 0 to day 84 was apparent in both groups (P < 0.0001). At the end of the study, both the pruritus score and the total clinical score were lower in the active group. Our findings indicate a steroid sparing effect of essential fatty acid supplementation in canine atopic dermatitis and, furthermore, that there is a time lag before the effect is attained.
Human study but who knows some vets may try it on dogs
BMJ. 2003 Jun 21;326(7403):1367. : Twice weekly fluticasone propionate added to emollient maintenance treatment to reduce risk of relapse in atopic dermatitis: randomised, double blind, parallel group study.
Berth-Jones J, Damstra RJ, Golsch S, Livden JK, Van Hooteghem O, Allegra F, Parker CA; Multinational Study Group.
Department of Dermatology, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Coventry CV2 2DX.
johnberthjones@a ol.com
OBJECTIVE: To explore the efficacy and safety of fluticasone propionate, cream and ointment, applied twice weekly in addition to maintenance treatment with emollients, in reducing the risk of relapse of chronic recurrent atopic dermatitis. DESIGN: Randomised, double blind, parallel group study of 20 weeks' duration. SETTING: Dermatology outpatient clinics (6 countries, 39 centres). PARTICIPANTS: Adult (aged 12-65) patients with moderate to severe atopic dermatitis who were experiencing a flare. METHODS: Participants applied fluticasone propionate (0.05% cream or 0.005% ointment; once or twice daily) regularly for four weeks to stabilise their condition. The patients whose disease was brought under control then continued into a 16 week maintenance phase, applying emollient on a daily basis with a bath oil as needed and either the same formulation of fluticasone propionate or its placebo base (emollient alone) twice weekly to the areas that were usually affected. MAIN OUTCOME MEASURE: Time to relapse of atopic dermatitis during maintenance phase. RESULTS: 376 patients entered the stabilisation phase, and 295 continued into the maintenance phase. After 16 weeks in the maintenance phase, the disease remained under control in 133 patients (87 using fluticasone propionate twice weekly, 46 using emollient alone), 135 (40 fluticasone propionate, 95 emollient) had experienced a relapse, and 27 had discontinued. Median time to relapse was six weeks for emollient alone compared with more than 16 weeks for additional fluticasone propionate. Patients who applied fluticasone propionate cream twice weekly were 5.8 times less likely (95% confidence interval 3.1 to 10.8, P < 0.001) and patients using fluticasone propionate ointment 1.9 times less likely (1.2 to 3.2, P=0.010) to have a relapse than patients applying emollient alone. The groups showed no differences in adverse events. CONCLUSION: After atopic dermatitis had been stabilised the addition of fluticasone propionate twice weekly to maintenance treatment with emollients significantly reduced the risk of relapse.
Vet Immunol Immunopathol. 2003 May 12;92(3-4):113-24. : Serum IgE and IgG responses to food antigens in normal and atopic dogs, and dogs with gastrointestinal disease.
Foster AP, Knowles TG, Moore AH, Cousins PD, Day MJ, Hall EJ.
Department of Clinical Veterinary Science, University of Bristol, Langford House, North Somerset BS40 5DU, Langford, UK

In human food allergy, with or without concurrent atopy, there may be significant increases in serum allergen-specific IgE. Serological methods have been tried but are not currently recommended for diagnosis of suspected food allergy in dogs. The aim of this study was to investigate humoral immune responses to food antigens in dogs. Serum IgG and IgE antibodies specific for food antigens were measured by enzyme linked immunosorbent assay (ELISA) using polyclonal anti-dog IgG and IgE reagents. Antigens tested were beef, chicken, pork, lamb, chicken, turkey, white fish, whole egg, wheat, soybean, barley, rice, maize corn, potato, yeast and cow's milk. Three groups were examined: normal dogs, dogs with atopic dermatitis (AD); and dogs with one of four types of gastrointestinal (GI) disease: small intestinal bacterial overgrowth (SIBO), inflammatory bowel disease (IBD), food-responsive disease, and infectious diarrhoea. Statistically significant differences in food-specific antibodies were not detected between the GI subgroups. There were statistically significant differences in the IgE concentration between the normal dogs, and dogs with atopic or GI disease, for all of the antigens tested. There were statistically significant differences in the average IgG concentrations between the normal dogs, and dogs with atopic or GI disease, for all of the antigens tested, except egg and yeast. The relationship of antigen responses for pooled data was analysed using principle component analysis and cluster plots. Some clustering of variables was apparent for both IgE and IgG. For example, all dogs (normal and diseased) made a similar IgG antibody response to chicken and turkey. Compared with other groups, atopic dogs had more food allergen-specific IgE and this would be consistent with a Th(2) humoral response to food antigens. Dogs with GI disease had more food allergen-specific IgG compared with the other groups. This may reflect increased antigen exposure due to increased mucosal permeability which is a recognised feature of canine intestinal disease.
Vet Dermatol. 2003 Feb;14(1):11-22. : Comparison of cyclosporine A with methylprednisolone for treatment of canine atopic dermatitis: a parallel, blinded, randomized controlled trial.
Steffan J, Alexander D, Brovedani F, Fisch RD.
Novartis Animal Health Inc., CH 4002, Basel, Switzerland.
Jean.steffan@ah.novartis.com

The objective of this multicentre, parallel, blinded, randomized controlled study was to evaluate the efficacy and the safety of cyclosporine (CsA group, 117 dogs) in comparison with methylprednisolone (MP group, 59 dogs) in the treatment of atopic dermatitis for 4 months. Mean induction dose of both drugs (5 mg/kg CsA, 0.75 mg/kg MP) was tapered over time according to the clinical response. At the end of the study, the mean estimated percentage reduction from baseline (confidence interval) of lesion scores was 52% (44-59) and 45% (35-56), and the reduction in pruritus score was 36% (27-43) and 33% (23-43) in dogs in the CsA and MP groups, respectively. These percentages were not significantly different between groups. A significantly better overall assessment of efficacy was obtained in the CsA-treated dogs (76 vs. 63% responses excellent or good in the CsA compared with MP group). CsA-treated dogs presented a higher frequency of gastrointestinal disorders, mainly vomiting, but MP dogs tended to be more susceptible to infections. There was no remarkable change over baseline of the haematological and biochemical parameters in the two groups.
Serum immunoglobulin E concentrations in West Highland White Terrier puppies do not predict development of atopic dermatitis
DJ DeBoer, PB Hill
2015 Linden Dr W,Madison,WI 53706 USA
Veterinary Dermatology, 1999, Vol 10, Iss 4, pp 275-281
Sera from 154 West Highland White Terrier puppies between 6 and 12 weeks of age were assayed for total IgE using a sandwich ELISA method. Development of clinical signs of atopic dermatitis in these dogs was monitored by use of an annual owner questionnaire, until the dog reached 3 years of age. Of 114 evaluated dogs, skin disease severe enough to warrant veterinary examination was reported in 52 (46%) during the three study years. A diagnosis of atopic dermatitis was made by the attending veterinarian in 28 dogs (25%). Certain litters had an especially high prevalence of apparently atopic dogs, consistent with the genetic predisposition towards atopy in this breed, but clear evidence of consistent heritability was not present. The median IgE concentration in 154 puppies at 6-12, weeks of age was 0.9 units mL(-1), with a skewed distribution. Significant (P < 0.01) variation in serum IgE concentrations was observed between litters, with median serum IgE concentrations for a litter ranging from 0 to 27.7 units mL(-1). The median serum IgE concentration in puppies that later developed clinical signs of atopic dermatitis was not significantly different from that of puppies that remained healthy. There were no apparent correlations or significant differences found between serum IgE concentration as a puppy, parental history of skin disease, and subsequent emergence of clinical signs of atopic dermatitis. We conclude that early total serum IgE determinations seem to have little usefulness in predicting the later onset of atopic dermatitis in this breed.
DIAGNOSIS OF ATOPIC DERMATITIS IN DOGS
M Nagata
Animal Dermatology Center, ASC, 1-3-2 Jindaijihigashi Chofu, Tokyo 182-0012, Japan
Waltham Focus Vol.11, No.2
KEY POINTS
Atopy is very common in dogs, particularly in certain predisposed breeds
The most common clinical sign is pruritus, particularly of the face, ears, ventral abdomen and feet from an early age
A diagnosis of atopy can be made by exclusion-systematically excluding all the differential diagnoses
The sole purpose of attempting to identify the inciting allergens is for the purpose of immunotherapy
INTRODUCTION
It has been estimated that between 20% and 75% of the small animals seen in the average practice have skin problems as a chief or concurrent owner complaint (1). In 1998, a nation-wide survey in Japan revealed that canine skin disorders are one of the most common reasons for patient visits to the veterinary clinic (2). The survey also revealed that the most common groups of canine skin disorders were infections and allergic diseases, and the most common final diagnoses, in descending order of incidence, were flea allergic dermatitis (FAD), pyoderma, otitis externa, atopic dermatitis (AD), and seborrhoeic dermatitis (2). The survey indicated that allergic skin disorders, especially FAD and AD, are quite frequently encountered at the veterinary clinic, and AD is undoubtedly a more complicated disorder than FAD. Thus, this paper will focus on canine AD and discussed the aetiology, clinical features, and diagnosis. The management of AD is discussed in the accompanying paper by Drs Harvey and Markwell.

Double-blinded, placebo-controlled, cross-over pilot study on the efficacy of zileuton for canine atopic dermatitis.
Crow DW, Marsella R, Nicklin CF.
Blanche Saunders Derm Lab, Dept of Small Animal Clin Sci, College of Vet Med, Univ of Fla, Gainesville, Florida, USA.
Vet Dermatol 2001 Aug;12(4):189-95
Nine dogs meeting the diagnostic criteria for canine atopic dermatitis were enrolled in a double-blind, placebo-controlled, cross-over clinical trial. In this pilot study, zileuton (a 5-lipoxygenase inhibitor) given orally at 2 mg kg-1 three times daily for 4 weeks significantly decreased erythema in dogs with atopic dermatitis but had no effect on pruritus. Zileuton was well tolerated and no adverse clinical signs were noted. However, one dog developed mild alanine aminotransaminase elevation, which resolved within 1 week of discontinuation of therapy. Monitoring of alanine aminotransaminase may be necessary in dogs receiving zileuton. Further studies with larger number of dogs are needed to evaluate the efficacy of zileuton as treatment for canine atopic dermatitis.
Treatment of canine atopic dermatitis with zafirlukast, a leukotriene-receptor antagonist: a single-blinded, placebo-controlled study.
Senter DA, Scott DW, Miller WH Jr.
Dept of Clin Sci, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853-6401, USA. Can Vet J 2002 Mar;43(3):203-6
Zafirlukast and placebo were administered orally as individual agents to 20 dogs with atopic dermatitis. The pruritus was effectively reduced by at least 50% in 2/18 (11%) dogs that completed the trial with zafirlukast. Two dogs vomited after administration of the active drug.
120x60_PetFoodDirect
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Vet Dermatol. 2003 Feb;14(1):37-46. : A randomized controlled trial of misoprostol monotherapy for canine atopic dermatitis: effects on dermal cellularity and cutaneous tumour necrosis factor-alpha
. Olivry T, Dunston SM, Rivierre C, Jackson HA, Murphy KM, Peters E, Dean GA.
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
Thierry_Olivry@ncsu.edu

In this blinded randomized placebo-controlled trial, 20 dogs with atopic dermatitis (AD) were given placebo (8 dogs) or misoprostol (12 dogs) at 5 micro g kg-1, orally, three times daily for 3 weeks. Administration of the active drug, but not of placebo, led to a significant decrease in lesional and pruritus scores. The median reduction from baseline of both scores was approximately 30%. Misoprostol therapy did not lead to decreases of dermal cell counts or skin tumour necrosis factor (TNF)alpha mRNA copy numbers that were significantly different from those of placebo. Skin TNFalpha protein production, assessed using indirect immunofluorescence, decreased or remained unchanged in dogs receiving misoprostol. In contrast, post treatment TNFalpha fluorescence scores were higher in all but two dogs given placebo. The changes from baseline of TNFalpha fluorescence scores did not correlate significantly with those of lesional or pruritus indices. These observations confirm the modest efficacy of misoprostol for treatment of canine AD and suggest that its mild anti-allergic effects are not associated with either inhibition of inflammatory cell emigration or TNFalpha production.
Am J Vet Res. 2003 Jan;64(1):32-6. : Serum immunoglobulin E against storage mite allergens in dogs with atopic dermatitis.
Arlian LG, Schumann RJ, Morgan MS, Glass RL.
Department of Biological Sciences, Wright State University, Dayton, OH 45435, USA.

OBJECTIVE: To determine the prevalence of serum IgE against the storage mites Acarus siro, Blomia tropicalis, and Tyrophagus putrescentiae in a population of dogs with atopic dermatitis. SAMPLE POPULATION: Sera from 84 dogs with atopic dermatitis residing in various regions of the United States and Europe. PROCEDURE: Immunoblotting of sera from atopic dogs was used to identify proteins in mite extracts that bound IgE. RESULTS: 94% of the dogs had serum IgE against proteins in extracts of 1 or more of the storage mite species. Ninety-five, 92, and 89% of the storage mite-sensitive dogs had serum IgE against proteins in extracts of A siro, B tropicalis, and T putrescentiae, respectively. Eighty-two percent had serum IgE against at least 1 protein in all 3 species. Most of the major allergens had molecular weights > 80 kd. A greater percentage of the dog sera had IgE against storage mite proteins, compared with proteins of the house dust mites Dermatophagoides farinae and D pteronyssinus. CONCLUSION AND CLINICAL RELEVANCE: Many dogs with atopic dermatitis have serum IgE against many allergens of storage mites. Most of these allergens, like allergens of dust mites, had molecular weights > 80 kd. Storage mite sensitivity in dogs may be as important, if not more important, than dust mite sensitivity.
Pediatr Allergy Immunol. 2002 Dec;13(6):394-401. : Exposure to pets and atopic dermatitis during the first two years of life. A cohort study.
Zirngibl A, Franke K, Gehring U, von Berg A, Berdel D, Bauer CP, Reinhardt D, Wichmann HE, Heinrich J; GINI study group.
GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
zirngibl@gsf.de

The aim of this study was to assess the association between keeping pets in early childhood and the occurrence of atopic dermatitis in an ongoing birth cohort followed up to the age of 2 years. We analyzed data of 4578 children in the intervention and observation part of an ongoing cohort study. The children were recruited at birth in the two study regions Wesel and Munich between January 1996 and June 1998. Information on atopic diseases and pet ownership was obtained by questionnaire at the child's first and second birthday. The logistic regression model showed a negative association between 'keeping any pet' and in particular 'keeping dogs' in the 1st year of life and the development of atopic dermatitis in the 1st and the 2nd years of life. The protective effects remained statistically significant after adjusting for several possible confounding variables (1st year(any) pet OR 0.71, 95% CI [0.55;0.92], 1st year(dog) OR 0.62, 95% CI [0.39;0.98], 2nd year(any) pet OR 0.74, 95% CI [0.57;0.97], 2nd year(dog) OR 0.63, 95% CI [0.40;0.98]). Ownership of small furred pets (hamster, rabbit and guinea pig) also showed a borderline protective effect for the 1st year. We assume an association between keeping pets and undefined environmental factor(s) that contribute protectively to the development of atopic dermatitis in early life, presumably by effects on the maturation of the immune system.
OFF TOPIC BUT SOMEWHAT RELATED RESEARCH STUDY RE INFANTS AND EXPOSURE TO ANIMAL'S DANDER AND ALLERGIES...A PLUS POSSIBLY
J Allergy Clin Immunol. 2003 May;111(5):938-46. : Early exposure to allergen: is this the cat's meow, or are we barking up the wrong tree?
Apter AJ.
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia 19104, USA.

Several recent studies have suggested that exposure to cat and dog allergen in infancy is protective against the subsequent risk of allergic sensitization and asthma. The methodologic problems to be overcome in clinical research addressing these hypotheses are complex. Appreciation of these studies requires an assessment of the design and adequacy of variables measuring exposures, outcomes, and confounders. It includes understanding the role of effect modification. This article discusses some of the epidemiologic issues in interpreting these studies. Review of relevant epidemiology demonstrates that much research remains to be performed before these interesting hypotheses are proved or disproved.
Res Vet Sci. 2002 Oct;73(2):153-8. : Fatty acid composition of serum lipids in atopic and healthy dogs.
Saevik BK, Thoresen SI, Taugbol O.
Department of Small Animal Clinical Sciences, The Norwegian School of Veterinary Science, P.O. Box 8146, Dep., N-0033 Oslo, Norway.
bente.k.saevik@veths.no

Fatty acids are increasingly used in the treatment of canine atopic dermatitis and their beneficial effects are documented in several prospective, controlled studies. Results from recent studies have indicated that atopic dogs have disordered fat metabolism, due to decreased desaturase activity. To further clarify these possible abnormalities, we examined serum fatty acid patterns in dogs with atopic dermatitis and normal controls. Atopic dermatitis was diagnosed according to the diagnostic criteria proposed by Willemse, after elimination of other possible causes of pruritic dermatitis. Both the relative and the absolute amounts of fatty acids in sera were determined by gas chromatography. Differences in the serum fatty acid pattern indicating a reduction in desaturase activity were not detected in atopic dogs when compared with controls.
Vet Immunol Immunopathol. 2002 Sep 10;87(3-4):351-6. : Immune dysregulation in atopic dermatitis.
Sinke JD, Rutten VP, Willemse T.
Department of Clinical Science of Companion Animals, Utrecht University, The Netherlands

Atopic dermatitis (AD) is a chronic inflammatory skin disease in humans and dogs with comparable clinical features. Comparative studies of immunological events in the pathogenesis of AD may contribute to understanding of the disease in dogs and to development and evaluation of immunomodulatory strategies of relevance to both species.Both allergen-specific as well as non-specific mechanisms contribute to the disease development. AD skin lesions are proposed to be initiated by activation of allergen-specific Th2-type cells, potentially influenced by local cutaneous factors. In the chronic stage of skin lesions reactivity may change into a Th1-type, e.g. driven by eosinophil derived IL-12. Analyses of these processes in course of time were performed in both spontaneous as well as in experimentally induced lesions (i.e. atopy patch test (APT) lesions). In the present paper, the immunological events as reported for human and canine AD are summarized and compared.
Vet Immunol Immunopathol. 2002 Sep 10;87(3-4):379-84. : T-helper 1, T-helper 2 and immunosuppressive cytokines in canine atopic dermatitis.
Nuttall TJ, Knight PA, McAleese SM, Lamb JR, Hill PB.
Department of Veterinary Clinical Science, University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Centre, Easter Bush, Midlothian EH25 9RG, UK.
timn@vet.ed.ac.uk

Atopic dermatitis is a common inflammatory skin disease of humans and dogs. Human atopic dermatitis is associated with T-helper (Th) 2 type responses, although Th1 cytokines are present in chronic lesions. This study used semi-quantitative reverse transcriptase polymerase chain reactions to determine the expression of gene transcripts for immunosuppressive cytokines (transforming growth factor beta [TGFbeta] and interleukin [IL]-10), Th2 type cytokines (IL-4 and IL-6) and Th1 type cytokines (interferon gamma [IFNgamma], tumour necrosis factor alpha [TNFalpha], IL-2 and IL-12) in lesional atopic, non-lesional atopic and healthy canine skin. Canine atopic dermatitis was associated with over-expression of IL-4 mRNA and reduced transcription of TGFbeta compared to healthy skin (ANOVA, p<0.05). Higher levels of IFNgamma, TNFalpha and IL-2 mRNA were seen in lesional compared to non-lesional and healthy skin (p<0.05). There were no significant differences in IL-10, IL-6 or IL-12 transcription. This is the first report to demonstrate that canine atopic dermatitis is associated with over-production of IL-4 and under expression of TGFbeta
Lancet. 2002 Aug 31;360(9334):691-2. : Frequency of atopy in the Arctic in 1987 and 1998
. Krause T, Koch A, Friborg J, Poulsen LK, Kristensen B, Melbye M.
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark. tgv@ssi.dk

Few studies have measured the frequency of atopy with objective measures, and most of these studies have been done in industrialised countries. We analysed serum samples from 859 15-80-year-old Greenlanders who had participated in population-based screening campaigns in 1987 and in 1998. We defined atopy as a positive result in an assay that tests for specific IgE against the eight most common inhalant allergens in one pool (grass, birch, mugwort, dog, cat, horse, Cladosporum herbarum, house dust mite). The frequency of atopy doubled between 1987 (39 [10%] of 392) and 1998 (87 [19%] of 467; risk ratio 1.88 [95% CI 1.31-2.68]). This increase was largest in 15-19-year olds, but also occurred in older people, suggesting that the risk factors responsible for the increase in atopy do not operate only in childhood.

Vet Dermatol. 2002 Jun;13(3):131-9. : The effects of capsaicin topical therapy in dogs with atopic dermatitis: a randomized, double-blinded, placebo-controlled, cross-over clinical trial.
Marsella R, Nicklin CF, Melloy C.
Blanche Saunders Dermatology Laboratory, University of Florida, Gainesville 32610-0126, USA.
MarsellaR@mail.vertmed.ufl.edu

The efficacy of twice daily topical application of capsaicin (0.025%) for the management of pruritus in dogs with atopic dermatitis (AD) was evaluated in double-blinded, placebo-controlled study. Twelve dogs with AD were randomly assigned to either 0.025% capsaicin or vehicle lotion applied twice daily for 6 weeks. After a 4-week wash-out period, treatments were switched. Significant improvement was reported by owners (P = 0.0006), but not by investigators. Owners noted temporary worsening of pruritus after the first week of capsaicin therapy. Overall capsaicin was well tolerated. Substance P (SP) concentrations in the skin did not correlate with the severity of the pruritus and did not change significantly over time and between treatments. Lesional skin had less SP than nonlesional skin (P = 0.03). These observations suggest that topical capsaicin should be further evaluated as an adjunctive antipruritic agent in dogs with AD.
Vet Dermatol. 2002 Apr;13(2):103-11. : Canine atopic dermatitis: a retrospective study of 169 cases examined at the University of California, Davis, 1992-1998. Part II. Response to hyposensitization.
Zur G, White SD, Ihrke PJ, Kass PH, Toebe N.
Koret Veterinary Teaching Hospital, School of Veterinary Medicine, The Hebrew University of Jerusalem, PO Box 12 Rehovot 76100, Israel.
zurgila@agri.huji.ac.il

One hundred and sixty-nine dogs were diagnosed with atopic dermatitis, and treated with hyposensitization for at least 1 year based on the results of either intradermal skin tests (IDST) or enzyme-linked immunosorbant serum assays (ELISA). Excellent (i.e. hyposensitization alone controlled clinical signs), good (> 50% improvement), moderate (< 50% improvement) and no (clinical signs were unchanged) responses were seen in 19.5, 32.5, 20.1 and 27.8%, respectively. Age of onset, age when treatment was initiated or the duration of clinical signs had no influence on response to hyposensitization. Dogs having concurrent flea allergy dermatitis were statistically more likely to respond better than dogs with concurrent food allergies. Although not statistically significant, there were trends for Golden Retriever and male dogs to respond better than other breeds and female dogs, respectively. Dogs having more than 21 positive reactions in allergy tests and treated with more than 21 allergens had lower response scores, and a longer time course before achieving beneficial response. Lower response scores were seen in dogs having positive reactions to cultivated plants, grasses, trees or insects. There was no difference in response to hyposensitization whether based on IDST or ELISA results.
Vet Pathol. 2002 Mar;39(2):228-33. : Interleukin 4-producing CD4+ T cells in the skin of cats with allergic dermatitis.
Roosje PJ, Dean GA, Willemse T, Rutten VP, Thepen T.
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.

Lesional skin of cats with allergic dermatitis has a cellular infiltrate and a CD4/CD8 ratio comparable to that in humans with atopic dermatitis. CD4+ helper T cells and in particular cells belonging to the Th2 subset play an important role in disease pathogenesis in humans. We investigated the cytokine pattern of CD4+ T cells in situ, with special emphasis on the putative presence of cells producing interleukin 4 (IL4), in cats with allergic dermatitis. Immunohistochemical procedures were used to determine that CD4+ T cells in lesional and nonlesional skin of cats with allergic dermatitis can produce IL4, as occurs in humans. Lesional and nonlesional skin of cats with allergic dermatitis had significantly more IL4+ T cells (P = 0.001) than did skin of healthy control cats. Double staining indicated that all IL4+ cells were positive for pan-T or CD4 markers. Double labeling for mast cell chymase and IL4 stained primarily different cells. Western blotting demonstrated cross-reactivity between the antibody against human IL4 and a feline recombinant IL4. These results indicate that IL4 is primarily produced by CD4+ T cells and is also present in clinically uninvolved skin, indicating a role in the pathogenesis of allergic dermatitis in cats.
Vet Dermatol. 2001 Jun;12(3):177-81. : Feline atopy in three littermates.
Moriello KA.
Department of Medical Sciences, School of Veterinary Medicine, 2015 Linden Drive West, Madison, WI 53706, USA.
derm.km@svm.vetmed.wisc.edu

This case report describes the history, clinical signs and diagnosis of a pruritic skin disease in three sibling cats living the same household. Clinical signs consistent with pruritus (i.e. hair pulling, hair loss, excessive grooming and face rubbing) were first noted when the cats were 6 months of age. The cats were treated for a possible ear mite and/or flea infestation; there was no response to treatment and clinical signs progressed. Although the presence of pruritus in a multiple cat household suggested an infectious or contagious aetiology, none could be identified. There was no improvement in clinical signs after a 60-day flea control trial, three treatments of ivermectin, an 8-week restricted diet or removal from the home for 10 days. A diagnosis of feline atopy was made on the basis of elimination of other causes of pruritus, consistent history and clinical signs, a positive intradermal skin test and response to therapy.