Efficacy of subcutaneous allergen immunotherapy in atopic dogs: A retrospective study of 664 cases.

BACKGROUND: Canine atopic dermatitis (cAD) is an allergic skin disease affecting approximately 10% of dogs. allergen-specific immunotherapy (ASIT) is currently the only treatment option able to induce tolerance to the causative allergens. OBJECTIVE: To retrospectively establish the efficacy of ASIT in atopic dogs. ANIMALS: Client-owned (n  = 664) dogs with cAD presented between 2008 and 2018 to two dermatology referral clinics. MATERIALS AND METHODS: Clinical records of atopic dogs were reviewed to obtain information including the results of the intradermal skin test and/or allergen-specific immunoglobulin (Ig)E serological results, the allergens included in the ASIT, concurrent symptomatic medications, and ASIT efficacy after at least 9 months. RESULTS: Excellent (ASIT alone controlled clinical signs), good (≥50% reduction of clinical signs) and poor (<50% improvement) responses were seen in 31.5%, 28.5% and 40.1% of the dogs, respectively. No significant differences in efficacy were associated with breed, sex, age at initiation of ASIT, type of allergens in ASIT, and between clinics. Dogs re-examined regularly responded significantly better to ASIT than dogs that did not (>50% improvement in 69.3% and 55.4% of the dogs, respectively). Dogs treated with ASIT and concomitant systemic glucocorticoids showed a significantly poorer response (success rate of >50% improvement of 38.5%). CONCLUSIONS AND CLINICAL IMPORTANCE: In 59.9% of atopic dogs, subcutaneous ASIT can improve clinical signs by ≥50%. The beneficial effect of ASIT is higher if dogs are re-examined regularly and if systemic long-term corticosteroids are avoided, at least during the first 9 months of ASIT.

Contexte - La dermatite atopique canine (DAC) est une maladie cutanée allergique qui touche environ 10 % des chiens. L'immunothérapie allergénique (ASIT) est actuellement la seule option thérapeutique capable d'induire une tolérance aux allergènes responsables. Objectif - Établir rétrospectivement l'efficacité de l'ASIT chez les chiens atopiques. Animaux - Chiens de clients (n = 664) atteints de DAC présentés entre 2008 et 2018 à deux cliniques de référé en dermatologie. Méthodes - Les dossiers cliniques des chiens atopiques ont été examinés pour obtenir des informations, notamment les résultats du test cutané intradermique et / ou les résultats sérologiques de l'immunoglobuline (Ig) E spécifique d'allergène, les allergènes inclus dans l'ASIT, les médicaments symptomatiques concomitants et l'efficacité de l'ASIT après au moins neuf mois. Résultats - Des réponses excellentes (signes cliniques contrôlés par l'ASIT seul), bonnes (réduction ≥ 50 % des signes cliniques) et médiocres (amélioration < 50 %) ont été observées chez 31,5 %, 28,5 % et 40,1 % des chiens, respectivement. Aucune différence significative d'efficacité n'a été associée à la race, au sexe, à l'âge au début de l'ASIT, au type d'allergènes dans l'ASIT et entre les cliniques. Les chiens réexaminés régulièrement ont répondu significativement mieux à l'ASIT que les chiens qui ne l'ont pas fait (amélioration > 50 % chez 69,3 % et 55,4 % des chiens, respectivement). Les chiens traités avec l'ASIT et des glucocorticoïdes systémiques concomitants ont montré une réponse significativement plus faible (taux de réussite > 50 % d'amélioration de 38,5 %). Conclusions et importance clinique - Chez 59,9 % des chiens atopiques, l'ASIT sous-cutanée peut améliorer les signes cliniques de ≥ 50 %. L'effet bénéfique de l'ASIT est plus élevé si les chiens sont réexaminés régulièrement et si les corticostéroïdes systémiques à long terme sont évités, au moins pendant les neuf premiers mois de l'ASIT.

Introducción- la dermatitis atópica canina (cAD) es una enfermedad alérgica de la piel que afecta aproximadamente al 10 % de los perros. La inmunoterapia con alérgenos (ASIT) es actualmente la única opción de tratamiento capaz de inducir tolerancia a los alérgenos causantes. Objetivo- establecer retrospectivamente la eficacia de ASIT en perros atópicos. Animales- perros de propietarios particulares (n=664) con cAD presentados entre 2008 y 2018 a dos clínicas de referencia de dermatología. Métodos- se revisaron las historias clínicas de los perros atópicos para obtener información, incluidos los resultados de la prueba cutánea intradérmica y/o los resultados serológicos de la inmunoglobulina (Ig)E específica para alérgenos, los alérgenos incluidos en el ASIT, los medicamentos sintomáticos concurrentes y la eficacia del ASIT después de al menos menos nueve meses. Resultados- se observaron respuestas excelentes (la ASIT sola controló los signos clínicos), buenas (≥50 % de reducción de los signos clínicos) y malas (<50 % de mejora) en el 31,5 %, 28,5 % y 40,1 % de los perros, respectivamente. No se asociaron diferencias significativas en la eficacia con la raza, el sexo, la edad al inicio de la ASIT, el tipo de alérgenos en la ASIT y entre las clínicas. Los perros reexaminados con regularidad respondieron significativamente mejor a la ASIT que los perros que no lo hicieron (>50 % de mejora en el 69,3 % y el 55,4 % de los perros, respectivamente). Los perros tratados con ASIT y glucocorticoides sistémicos concomitantes mostraron una respuesta significativamente peor (tasa de éxito de >50 % de mejora del 38,5 %). Conclusiones e importancia clínica - En el 59,9% de los perros atópicos, la ASIT subcutánea puede mejorar los signos clínicos en ≥50%. El efecto beneficioso de la ASIT es mayor si los perros se vuelven a examinar con regularidad y si se evitan los corticosteroides sistémicos a largo plazo, al menos durante los primeros nueve meses de la ASIT.

Contexto - A dermatite atópica canina (DAC) é uma doença alérgica que afeta aproximadamente 10% dos cães. A imunoterapia alérgeno-específica (ASIT) é atualmente a única opção terapêutica capaz de induzir tolerância aos alérgenos causadores. Objetivo - Estabelecer retrospectivamente a eficácia da ASIT em cães atópicos. Animais - Cães de proprietários (664) com DAC apresentados a duas clínicas de referência em dermatologia entre 2008 e 2018. Métodos - Os prontuários dos cães atópicos foram revisados para se obter informações incluindo os resultados dos testes intradérmicos e/ou sorológicos para anticorpos (IgE) alérgeno-específicos, os alérgenos incluídos na ASIT, medicações sintomáticas concomitantes, e a eficácia de ASIT após um mínimo de nove meses. Resultados - Resposta excelente (ASIT controlou os sinais clínicos sozinha), boa (redução ≥50% nos sinais clínicos) e pobre (<50% de melhora) foi observada em 31,5%, 28,5% e 40,1% dos cães, respectivamente. Não foram observadas diferenças significativas na eficácia em relação a raça, gênero, idade à iniciação da ASIT, tipo de alérgenos na ASIT e entre as clínicas. Os cães reavaliados periodicamente responderam significativamente melhor à ASIT que cães que não foram reavaliados com frequência (>50% de melhora em 69,3% e 55,4% dos cães, respectivamente). Cães tratados com ASIT e glicocorticoides sistêmicos concomitantemente demonstraram uma resposta significativamente mais pobre (a taxa de sucesso >50% ocorreu em 38,5%). Conclusões e importância clínica - Em 59,9% dos cães atópicos, ASIT subcutânea é capaz de melhorar os sinais clínicos em ≥50%. O efeito benéfico de ASIT foi maior se os cães fossem reavaliados regularmente e se corticoides sistêmicos a longo prazo fossem evitados, ao menos durante os primeiros meses de ASIT.

Abnormal sebaceous gland differentiation in 10 kittens ('sebaceous gland dysplasia') associated with generalized hypotrichosis and scaling.

A rare congenital dermatosis, characterized by progressive hypotrichosis with variable scaling and crusting, occurred in 10 short-haired kittens in North America and Europe. Lesions appeared at between 4 and 12 weeks of age, commencing on the head and becoming generalized. The tail was spared in two kittens. Generalized scaling was mild to moderate, often with prominent follicular casts. Periocular, perioral, pinnal and ear canal crusting was occasionally severe. The skin was thick and wrinkled in two kittens. Histologically, the main lesion was abnormal sebaceous gland morphology. Instead of regular differentiation from basal cells to mature sebocytes, the glands were composed of a haphazard collection of undifferentiated basaloid cells, some partly vacuolated and a few containing eosinophilic globules. Mitotic figures and apoptotic cells were present in an irregularly thickened follicular isthmus. Lymphocytic mural folliculitis and mild sebaceous adenitis were rare. Orthokeratotic hyperkeratosis and follicular casts were present. Hair follicles were of normal density and were mostly in anagen, but some contained malacic hair shafts. Perforating folliculitis, leading to dermal trichogranuloma formation, occurred occasionally. Further biopsy samples taken at 2 years and at 3 and 4 years, respectively, from two kittens revealed similar but often more severe sebaceous gland lesions. Hair follicles were smaller, with many in telogen. The young age of onset suggests a genetic defect interfering with sebaceous and, possibly, follicular development. These lesions are discussed with reference to studies of mouse mutants in which genetic defects in sebaceous differentiation cause a similar phenotype of hyperkeratosis and progressive alopecia.