DeBoer D J, Hillier A
Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive West, Madison, WI 53706, USA.
Vet Immunol Immunopathol. 2001 Sep 20;81(3-4):271-6. doi: 10.1016/s0165-2427(01)00312-9.
The clinical signs of atopic dermatitis (AD) in man and in dogs are variable, and there is no single physical or historical feature that, if present, indicates the presence of AD. The initial diagnosis of AD is made clinically with the fulfillment of a combination of criteria that are strongly associated with the disease. Several schemes have been proposed in an attempt to define uniform clinical criteria for diagnosing canine AD, but no system is perfect. Once AD is considered as a possible diagnosis, other important differential diagnoses must be methodically eliminated from consideration. As a final step, once the clinician is certain that AD is probable, "allergy" tests may be conducted to provide additional evidence to "substantiate" the diagnosis. It is important to understand that allergy testing, in whatever form, is not appropriately used early in the patient evaluation as a screening test. Rather, it should be reserved, after a firm clinical diagnosis of AD has been made, to implement allergen avoidance schemes or to select allergens to be incorporated in immunotherapy formulations.
人类和犬类特应性皮炎（AD）的临床症状各不相同，不存在单一的体格检查或病史特征可用于确诊AD。AD的初步诊断是基于临床症状满足与该病密切相关的一系列标准。为了定义统一的犬类AD临床诊断标准，人们提出了多种方案，但没有一种系统是完美的。一旦考虑AD为可能的诊断，必须有条不紊地排除其他重要的鉴别诊断。最后一步，一旦临床医生确定很可能是AD，可进行“过敏”测试以提供额外证据来“证实”诊断。必须明白，无论采用何种形式，过敏测试在患者评估早期作为筛查测试使用并不合适。相反，应在对AD做出明确的临床诊断后再进行，以实施过敏原回避方案或选择用于免疫治疗制剂的过敏原。
