Olivry Thierry, DeBoer Douglas J, Favrot Claude, Jackson Hilary A, Mueller Ralf S, Nuttall Tim, Prélaud Pascal
Department of Clinical Sciences and Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
Vet Dermatol. 2010 Jun;21(3):233-48. doi: 10.1111/j.1365-3164.2010.00889.x. Epub 2010 Apr 23.
Atopic dermatitis (AD) is a common chronic relapsing pruritic skin disease of dogs for which treatment has varied over time and geographical location. Recent high quality randomized controlled trials and systematic reviews have established which drugs are likely to offer consistent benefit. The International Task Force for Canine AD currently recommends a multi-faceted approach to treat dogs with AD. Acute flares should be treated with a combination of nonirritating baths and topical glucocorticoids, once an attempt has been made to identify and remove the suspected causes of the flare. Oral glucocorticoids and antimicrobial therapy must be added when needed. In dogs with chronic AD, a combination of interventions should be considered. Again, factors that trigger flares of AD must be identified and, if possible, avoided. Currently recognized flare factors include food, flea and environmental allergens, Staphylococcus bacteria and Malassezia yeast. Skin and coat hygiene and care must be improved by bathing with nonirritating shampoos and dietary supplementation with essential fatty acids. The severity of pruritus and skin lesions can be reduced with a combination of anti-inflammatory drugs. Currently, medications with good evidence of high efficacy include topical and oral glucocorticoids, and calcineurin inhibitors such as oral ciclosporin and topical tacrolimus. The dose and frequency of administration of these drugs should be tailored to each patient considering each drug's efficacy, adverse effects and cost. Allergen-specific immunotherapy should be offered, whenever feasible, in an attempt to prevent recurrence of clinical signs upon further exposure to environmental allergens to which the patient is hypersensitive.
特应性皮炎（AD）是犬类常见的慢性复发性瘙痒性皮肤病，其治疗方法随时间和地理位置的不同而有所变化。最近的高质量随机对照试验和系统评价已经确定了哪些药物可能会带来持续的益处。国际犬类特应性皮炎特别工作组目前建议采用多方面的方法来治疗患有特应性皮炎的犬类。一旦尝试识别并消除引发急性发作的可疑原因，就应使用无刺激性浴液和外用糖皮质激素联合治疗急性发作。必要时必须添加口服糖皮质激素和抗菌治疗。对于患有慢性特应性皮炎的犬类，应考虑综合干预措施。同样，必须识别并尽可能避免引发特应性皮炎发作的因素。目前公认的发作因素包括食物、跳蚤和环境过敏原、葡萄球菌和马拉色菌酵母。必须使用无刺激性洗发水洗澡并补充必需脂肪酸进行饮食补充，以改善皮肤和被毛的卫生状况及护理。使用抗炎药物联合治疗可减轻瘙痒和皮肤病变的严重程度。目前，有充分证据证明高效的药物包括外用和口服糖皮质激素，以及钙调神经磷酸酶抑制剂，如口服环孢素和外用他克莫司。应根据每种药物的疗效、不良反应和成本，为每位患者量身定制这些药物的给药剂量和频率。只要可行，就应提供过敏原特异性免疫疗法，以试图防止患者在再次接触其过敏的环境过敏原时临床症状复发。
