Atopy

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Cost considerations, Pathogenesis, Predisposing factors, Pathophysiology, Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Differential diagnosis, Treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Rosanna Marsella DVM DipACVD
Dr Ian Mason BVetMed PhD CertSAD DipECVD MRCVS
Mr David Scarff BVetMed CertSAD MRCVS
Synonyms Atopic disease, atopic dermatitis

Introduction

  • Cause : reaction to environmental allergens.
  • Signs : variable but include symmetrical alopecia, miliary dermatitis, eosinophilic plaques and pruritus of head and neck.
  • Diagnosis : intradermal skin test; elimination of other causes of pruritus; history and clinical signs.
  • Prognosis : control likely.

Diagnosis

Clinical signs

  • Evidence of self trauma - excoriation, broken hair shafts .
  • Non-inflammatory symmetrical alopecia  Skin: atopy and food allergy - acute   Skin: atopy - Persian 2 years  .
  • Eosinophilic granuloma complex lesions  Skin: eosinophilic granuloma - mouth   Skin: eosinophilic ulcer on mouth - DSH  .
  • Miliary dermatitis  Skin: miliary dermatitis - DSH 8 years  .
  • Initially non-lesional pruritus, especially affecting head and neck.
  • Lymphadenopathy in chronic cases especially if miliary dermatitis, excoriation or eosinophilic plaques present.
  • Self-trauma to face and feet.
  • Ceruminous pruritic otitis externa .
  • Sneezing  Sneezing  .
  • Chronic coughing.

Diagnosis

Differential diagnosis

  • Causes of pruritus.
  • Causes of miliary dermatitis  Dermatitis: miliary  .
  • Causes of symmetrical alopecia.
  • Causes of eosinophilic granuloma complex lesions  Eosinophilic granuloma complex  .

Sequelae

Prognosis

  • Good if seasonally affected.
  • May develop multiple allergies over succeeding years   →   increased difficulty in control.

Reasons for treatment failure

  • Failure to diagnose concurrent disease, eg flea allergy, food sensitivity.
  • Many cases become less responsive to glucocorticoids with the passage of time - frequently due to a failure to manage concurrent disease.
  • Inability of client to cope with treatment schedules.

Sources

Publications

Refereed papers

  • Last R D, Suzuki, Y, Manning T, Lindsay D, Galipeau L & Whitbread, T J (2004)A case of fatal systemic toxoplasmosis in a cat being treated with cyclosporin A for feline atopy.Vet Dermatol.15(3), 194-198.DOI
  • Moriello K A (2001)Feline atopy in three littermates.Vet Dermatol12(3), 177-181.
  • Gilbert S & Halliwell R E (1998)Feline immunoglobin E - induction of antigen-specific antibody in normal c levels in spontaneously allergic cats.Vet Immunol Immunopathol63(3), 235-252.
  • Roosje P Jet al(1997)Feline atopic dermatitis - a model for Langerhans cell participation in disease pathogenesis.Am J Pathol151(4), 927-932.
  • Scott D W & Miller W H Jr (1993)Medical management of allergic pruritus in the cat, with emphasis on feline atopy.J S Afr Vet Assoc64(2), 103-108.

Other sources of information

  • Fadok V A (1995)Three feline dermatologic syndromes and their relationship to allergy.Proceedings of 1995 North American Conference Orlando, Florida Jan 14-18.

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