Treating canine atopic dermatitis usually involves a combination of therapeutic modalities. The mainstay of treatment is allergen-specific
immunotherapy (allergy vaccines) (Figure 2), cyclosporine (Atopica—Novartis Animal Health), and low-dose alternate-day oral glucocorticoids. Adjunctive treatment includes
antibiotics and antifungals to eliminate infection, strict flea control, diet trials, antihistamines, shampoos, and fatty
2. An intradermal skin test in a dog with positive test results. These results are used to guide the formulation of allergen-specific
NEW TOPICAL THERAPIES
Some new topical therapies have been developed with the goal of improving epidermal barrier function. The theory is that topically
applying lipids to the skin stimulates it to produce its own lipids, leading to barrier repair. These therapies are different
from supplementing fatty acids because they are administered directly onto the skin and because many of them provide ceramides,
the most important lipid component of the skin barrier. It has been shown that the skin barrier cannot be disrupted unless
ceramides are removed.6
Allerderm Spot-On (Virbac Animal Health; $20 to $30 for a six-pack), a ceramide and fatty acid-containing liquid, is applied
to the skin in a similar manner to monthly flea control products (Figure 3). The instructions for this product are to apply one pipette a week for four weeks and then one pipette a month for maintenance.
A small study that evaluated skin biopsy samples with electron microscopy showed that after repeated application of this product,
atopic dogs had higher concentrations of lamellar lipids in the stratum corneum compared with pretreatment concentrations.8
3. Allerderm Spot-On (Virbac Animal Health), a ceramide and fatty acid-containing liquid, has been shown to increase the concentration
of lamellar lipids in the stratum corneum of atopic dogs.
Dermoscent Essential 6 spot-on (Laboratoire De Dermo-Cosmetique Animale, Castres, France; $15 to $20 for a four-pack) contains
essential oils and fatty acids (Figure 4). The instructions for this product are to apply one pipette a week for eight weeks and then one pipette every two weeks
for maintenance. In a small study, seven atopic dogs were treated with this product for eight weeks and had their canine atopic
dermatitis extent and severity index (CADESI) scores measured before and after treatment.9 They had statistically significant improvement (P = 0.0043) in severity of disease, though there was not a control group.
4. Dermoscent Essential 6 spot-on (Laboratoire De Dermo-Cosmetique Animale, Castres, France) has been shown to decrease the
severity of atopic dermatitis, pruritus, and transepidermal water loss in atopic dogs.
Sogeval Laboratories makes a line of products containing phytosphingosine, a precursor to ceramides (Figure 5). Douxo Seborrhea Shampoo (Sogeval Laboratories; $50 to $65 for a 25-pack) can be used one or two times a week along with
the Douxo Seborrhea Micro-emulsion Spray (Sogeval Laboratories). Duoxo Seborrhea Spot-on (Sogeval Laboratories) can be used
alone or in combination with the shampoo or spray and should be applied once weekly for four weeks and then twice monthly
5. (Left to right) Douxo Seborrhea Shampoo, Seborrhea Micro-emulsion Spray, and Seborrhea Spot-on (Sogeval Laboratories) are
a line of phytosphingosine-containing products.