Alternative clinical approaches to the treatment of pruritis related to canine atopic dermatitis

Abstract

Canine atopic dermatitis (CAD) is a genetically inheritable, inflammatory and pruritic skin disease with characteristic clinical features, most commonly associated with IgE antibodies to environmental allergens. The most prominent clinical finding is itching. Depending on the allergens involved, seasonal or non-seasonal pruritus may occur. The face, inner part of the auricle, abdomen, inguinal region, perineal area and distal extremities are the most affected areas in atopic dermatitis. The main therapeutic goal when treating CAD is to stop itching quickly and safely to minimize skin damage and improve the patient's quality of life. In the first active phase of pruritis treatment, which consists of two stages, acute exacerbations should be controlled by using drugs with active ingredients such as corticosteroids, oclacitinib, lokivetmab. In the proactive pruritis treatment, it is aimed to prevent exacerbations and prolong the pruritus-free period with maintenance treatment. For this purpose, in addition to the drugs used in active treatment, different treatment options such as cyclosporine, tacrolimus, antihistamines, essential fatty acids, Palmitoylethanolamide (PEA), topical drugs and shampoos that help repair the skin barrier are used. Due to the side effects and costs of the drugs used in the treatment of pruritis in atopic dermatitis, research on alternative treatment methods continues. Applications such as mesenchymal stem cell therapy, recombinant canine gamma-interferon, luteolin, lactoferricin/verbascoside and vaccination against IL31 are among the alternative treatment methods for atopic dermatitis in dogs. However, more studies are needed before they can be included in our routine practices and added to the guidelines. In this review, it is aimed to transfer new treatments used for itching in atopic dermatitis to veterinary clinical practice and to encourage their routine use.

Keywords

• canine atopic dermatitis (CAD)
• pruritus
• alternative therapy
• dog