Development and validation of a graphic 2D investigator's global assessment instrument for grading the overall severity of atopic dermatitis in dogs.

BACKGROUND: Clinical trials enrolling dogs with atopic dermatitis (AD) use validated instruments that aggregate the extent and severity of selected skin lesions; none of these provides a global assessment of the severity of all lesions. OBJECTIVES: To validate an Investigator Global Assessment (IGA) instrument to globally evaluate the severity of skin lesions in dogs with AD. ANIMALS: Forty dogs with AD. METHODS AND MATERIALS: A 2D graphic IGA (2D-IGA) instrument was created to subjectively score, with a single dot, the overall extent and severity of all canine AD lesions. This tool was tested for its validity (content, construct and criterion), reliability (inter- and intraobserver) and sensitivity to change. RESULTS: The content of the 2D-IGA was first validated by a supportive vote by the International Committee of Allergic Diseases of Animals (ICADA) membership. Its construct was verified by positive correlations between the 2D-IGA scores and those of the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and the Canine Atopic Dermatitis Lesion Index (CADLI) (Spearman's rank-order correlation, P < 0.0001). The positive correlation (P < 0.0001) between an Owner Global Assessment of Disease Severity (OGADS) and the 2D-IGA indirectly satisfied its criterion. Scores graded by the same investigator hours apart and those between investigators were positively correlated (P < 0.0001), thereby validating this scale's intra- and interobserver reliabilities. Finally, the changes in 2D-IGA values during treatment were correlated positively with scores of an Owner Global Assessment of Treatment Efficacy (OGATE; P < 0.0001), thus showing its sensitivity to change. CONCLUSIONS AND CLINICAL IMPORTANCE: This novel 2D-IGA is a simple static graphic instrument that could be useful for clinical trials testing the efficacy of interventions for canine AD.

Rapid response of hyperkeratotic erythema multiforme to oclacitinib in two dogs.

BACKGROUND: Hyperkeratotic erythema multiforme (HKEM) is a clinically distinct dermatosis and poorly characterized syndrome, comprised of hyperkeratotic plaques with variable symmetry and apoptosis similar to "classic" erosive canine EM. Hyperkeratotic EM has a protracted clinical course and, although treatments with glucocorticoids, azathioprine and/or ciclosporin have been tried, rates of remission are low. OBJECTIVES: To describe successful treatment of HKEM in two dogs using oclacitinib. ANIMALS: A 7-year-old, spayed Havanese dog (Case 1) and a 1-year-old, intact cryptorchid Dachshund dog (Case 2). METHODS: Case characterization and clinical diagnoses were based on lesion character, surgical biopsy, cytological evaluation, culture, direct immunofluorescence (DIF) and expected responses to treatments. RESULTS: Both cases exhibited multifocal, often symmetrical hyperkeratotic plaques with adherent scale. Histological findings revealed prominent epidermal hyperplasia, parakeratotic hyperkeratosis, lymphocytic dermatitis and transepidermal apoptosis with lymphocytic satellitosis. DIF revealed fine, patchy IgG, IgM and IgA basement membrane deposits (Case 2). Both dogs exhibited rapid improvement with oral oclacitinib (0.6-0.9 mg/kg twice daily) with a complete remission of clinical signs observed in 12 and seven weeks in cases 1 and 2, respectively. CONCLUSION AND CLINICAL IMPORTANCE: Oclacitinib could be considered as a fast-acting and effective treatment option for HKEM in dogs.

The prevalence of bacterial infections during cyclosporine therapy in dogs: A critically appraised topic.

Cyclosporine is used to treat immune-mediated and allergic conditions and to prevent transplant rejection. To determine the prevalence of bacterial infections during cyclosporine therapy in dogs, 2 databases were searched and 14 articles reporting usable data were identified. In 828 dogs with atopic dermatitis receiving anti-allergic dosages of cyclosporine, the prevalence of bacterial infections was 11%; these occurred most often in the integument and urinary systems and not in multiple systems. In 95 dogs receiving cyclosporine at higher dosages for other conditions, the prevalence of bacterial infection was 17%, and these infections occurred most often in the gastrointestinal, urinary, and respiratory systems, often occurring at more than one body site. The prevalence of bacterial infections in atopic dogs treated with cyclosporine is low and occurs most often in the skin. When given for immunosuppression, the prevalence of bacterial infections is higher and can affect one or more body systems.

Prévalence d'infections bactériennes durant la thérapie à la cyclosporine chez les chiens : un sujet évalué de manière critique. La cyclosporine est utilisée pour traiter des conditions allergiques et à médiation cellulaire et également pour prévenir le rejet de greffe. Afin de déterminer la prévalence d'infections bactériennes durant la thérapie à la cyclosporine chez le chien, deux bases de données furent recherchées et 14 articles rapportant des données utilisables furent identifiés. Chez 828 chiens avec une dermatite atopique recevant des dosages antiallergiques de cyclosporine, la prévalence d'infections bactériennes était de 11 %; celles-ci survenaient le plus souvent dans les systèmes tégumentaire et urinaire mais pas dans des systèmes multiples. Chez 95 chiens recevant de la cyclosporine à des dosages plus élevés pour d'autres conditions, la prévalence d'infections bactériennes était de 17 %, et ces infections survenaient le plus souvent dans les systèmes gastro-intestinal, urinaire et respiratoire, se rencontrant souvent dans plus d'un site corporel. La prévalence d'infections bactériennes chez des chiens atopiques recevant de la cyclosporine est faible et survient le plus souvent au niveau de la peau. Lorsqu'administrée pour immunosuppression, la prévalence d'infections bactériennes est plus élevée et elles peuvent affecter un ou plus d'un système du corps.(Traduit par Dr Serge Messier).