Alergiczne zapalenie skóry – dylemat staje się coraz mniej problematyczny. Część I. Cechy kliniczne oraz diagnoza atopowego zapalenia skóry

Allergic dermatitis – a dilemma getting easier. Part I. Clinical features and diagnosis of a topic dermatitis

Allergy season will soon be here, and for most of us that means a new influx of scratching pets appearing at our practices. Though diagnosing allergy can be complicated, there’s hope on the horizon: new studies on diagnostic criteria are making it easier and quicker to establish a clinical diagnosis, and improvements in serologic allergy testing are both facilitating treatment and enabling more owners to access these tests for a more reasonable price. Part I of this article will discuss clinical diagnosis; Part II will focus on serologic allergy testing.

One of the most important basic principles to understand about diagnosis of allergy is that initial diagnosis is achieved mostly by clinical observation – not with a laboratory test. We are all familiar with the pet with a sudden appearance of dorsal lumbo-sacral pruritus and lesions and the finding of flea stool on the pet, where we can make a clinical diagnosis of flea allergy dermatitis without seeing the actual culprit scurrying around through the haircoat. The clinical appearance is distinctive. In the same way, recent epidemiologic studies of itchy dogs have uncovered lists of certain clinical criteria that are highly associated with canine atopic dermatitis (AD), and can help to differentiate it from other causes of itch such as parasites and infections.

History

History is an extremely important issue in all skin diseases, but especially in diagnosing allergy, where there are some important historical clues that you may be dealing with an allergic pet. A prominent feature of AD is pruritus, which may be initially unassociated with lesions. The pruritus almost always starts before 3 years of age, may be seasonal at first, and may worsen over time. It is most typically evident on the feet, face, ears, and/or ventral body surfaces. Breed predispositions must be considered. If corticoste...