Luisa Cornegliani

Comparable efficacy of a topical 0.0584% hydrocortisone aceponate spray and oral ciclosporin in treating canine atopic dermatitis

This study compared the efficacy of a 0.0584% hydrocortisone aceponate (HCA) spray (Cortavance(®); Virbac SA) and ciclosporin (Atopica(®); Novartis Animal Health) in canine atopic dermatitis in a single-blind randomized controlled trial. Dogs received HCA (two sprays/100 cm(2); n=24) or ciclosporin (5 mg/kg; n=21). Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03, pruritus (visual analog scale with grade descriptors) and owner scores (5-point scales) were recorded every 28 days for 84 days. Intention-to-treat data were analysed. CADESI-03 and pruritus significantly decreased over time (P<0.0001), but there was no difference between the treatment groups (P=0.91 and P=0.52, respectively). Similar proportions of HCA- and ciclosporin-treated dogs achieved ≥50% reductions in CADESI-03 and pruritus scores at 28 days (CADESI-03 58.3 and 57.1%, P=0.76; pruritus 33.3 and 38.1%, P=1.0), 56 days (CADESI-03 70.8 and 81.0%, P=1.0; pruritus 62.5 and 57.1%, P=1.0) and 84 days (CADESI-03 75 and 85.7%, P=0.72; pruritus 65.2 and 57.1%, P=0.76). The CADESI-03 and pruritus scores were close to equivalence (0.47 and 0.51, respectively). By 84 days, every-other-day or twice-weekly therapy was achieved in 13 of 24 HCA- and 12 of 21 ciclosporin-treated dogs (P=0.85). There were no significant differences in scores for efficacy (P=0.82), tolerance (P=0.62) and ease of administration (P=0.25). Scores for tolerance (0.49) and administration (0.46) were close to equivalence. The score for efficacy favoured HCA (0.68). Mild adverse events were noted in six of 21 ciclosporin and none of 24 HCA dogs (P=0.008). Five HCA-treated dogs and three ciclosporin-treated dogs were prematurely withdrawn (P=0.7). In conclusion, HCA and ciclosporin proved equally effective in treating canine atopic dermatitis for up to 84 days.

Transepidermal water loss in healthy and atopic dogs, treated and untreated: a comparative preliminary study

An impaired skin barrier function is thought to be crucial for allergic sensitization. In humans, the skin barrier is assessed by noninvasive methods, such as the measurement of transepidermal water loss (TEWL). Although limitations have been reported, measurement of TEWL has been demonstrated to be a suitable method to assess barrier function indirectly in dogs. The purposes of this prospective clinical study were twofold. The first aim was to evaluate and compare TEWL in healthy and atopic dogs. The second aim was to evaluate TEWL in a population of atopic dogs and to assess TEWL in dogs whose disease was in remission after successful therapy and compare it with dogs whose disease was not controlled or receiving treatment. One hundred and fifty dogs were selected and divided into the following three groups: 50 atopic dogs before specific treatment (group A); 50 in remission (group B); and 50 control dogs (group C). The mean values for TEWL for each group were 22.47 (g/m(2) h) (group A; 95% confidence interval 20.85-24.09), 12.57 (g/m(2) h) (group B; 95% confidence interval 11.43-13.7) and 8.81 (g/m(2) h) (group C; 95% confidence interval 8.09-9.52); P-value was 0.0001 for TEWL (groups A, B and C). This study showed a significant difference of TEWL between healthy control dogs and dogs with atopic dermatitis. Additionally, TEWL was lower in atopic dogs whose disease was in remission due to treatment. These results were consistent with reports in human medicine about TEWL.

Detection of feline herpes virus 1 via polymerase chain reaction and immunohistochemistry in cats with ulcerative facial dermatitis, eosinophilic granuloma complex reaction patterns and mosquito bite hypersensitivity

Ulcerative dermatitis caused by feline herpes virus 1 (FHV-1) is an uncommon disease characterized by cutaneous ulcers secondary to epidermal, adnexal and dermal necrosis. Differential diagnoses for FHV-1 lesions include, but are not limited to, mosquito bite hypersensitivity and eosinophilic granuloma complex. Histopathological diagnosis of FHV-1 dermatitis is based on the detection of the intranuclear inclusion bodies. In cases where intranuclear inclusions are missing but clinical and histological findings are compatible with FHV-1 dermatitis, immunohistochemistry (IHC) and PCRs have been used. In this retrospective study, we evaluated the presence of FHV-1 by IHC and PCR in skin biopsies and compared the results of the two tests. Sixty-four skin biopsy specimens from cats with compatible lesions were reviewed and tested via PCR and IHC for evidence of FHV-1. Polymerase chain reaction was positive in 12 of 64 biopsies; PCR and IHC were positive only in two of 64 biopsies, and these cases were considered true positive cases. The higher number of PCR-positive cases was possibly attributed to amplification of viral DNA from a live attenuated vaccination, but a previous FHV-1 infection with subsequent amplification of latently inserted FHV-1 could not be excluded. If clinical signs and histopathology suggest FHV-1 infection in the absence of typical inclusion bodies, IHC is the preferred diagnostic test; PCR may be useful for initial screening, but due to false positives is not sufficient for a definitive diagnosis.

Canine nodular dermatophytosis (kerion): 23 cases.

Dermatophytosis is a common zoonotic disease, and one of its clinical presentations in the dog is nodular dermatophytosis (kerion). Because the infection is located within the dermis, routine diagnostic tests such as a Woods lamp examination, microscopic examination of hair shafts for fungal elements and fungal culture can yield negative results. In such cases, histopathological examination with routine and special stains (periodic acid-Schiff, Gomori methenamine silver) is required to confirm the diagnosis. Nodular dermatophytosis in 23 dogs of different breed, age and sex with single or multiple nodules is described. Twelve dogs had a single nodule, and 11 dogs showed multiple lesions. Woods lamp examination was negative in all cases. Microscopic examination of plucked hairs showed arthrospores in 8 of 23 cases. Skin scrapings in mineral oil looking for arthrospores and/or hyphae were positive in 12 cases. Impression smears of exudates were diagnostic in 21 of 23 cases (91%), showing arthrospores within fragments of hair shafts or free among neutrophils and macrophages (pyogranulomatous inflammation). Histopathology was performed in two cases. Fungal culture was positive for Microsporum canis in 16 dogs and for Microsporum gypseum in one dog. In six cases, the causative agent was not identified by fungal culture. All dogs were treated with systemic antifungal therapy and in eight cases with concurrent antibiotic therapy. Nodular dermatophytosis resolved in all dogs with the prescribed treatments within 4 to 8 weeks. Transmission to people or other pets in the home was not found.

Lymphocyte subpopulations and Treg cells in dogs with atopic dermatitis receiving ciclosporin therapy: a prospective study

BACKGROUND Canine atopic dermatitis (CAD) is a chronic dermatological disease partly due to dysregulation of the immune system. Inappropriate activation of CD4(+) lymphocytes could favour and promote the allergic response. An inadequate activation system of regulatory T cells (Tregs) is suspected to be a key immunological feature of the allergic response in atopic dogs. HYPOTHESIS/OBJECTIVES To evaluate the difference in the CD4/CD8 lymphocyte ratio and the percentage of Tregs in healthy dogs, in a breed predisposed to CAD, and in dogs affected by CAD before and during therapy with ciclosporin (CsA). Additionally to assess the improvement in pruritus and skin lesions during therapy with CsA, and to compare this with CD4/CD8/Treg values. ANIMALS Ten atopic dogs of different breed, sex and age, ten healthy dogs and ten English bulldogs were included. METHODS Peripheral blood from all dogs was tested using flow cytometry to assess the CD4/CD8 ratio and percentage of Tregs. For atopic dogs, sampling was repeated after 30 and 90 days of therapy with CsA. RESULTS The CD4/CD8 ratio was not significantly different between the three groups. The Treg percentage was higher, but not statistically significant, in atopic dogs compared with controls. Therapy with CsA led to clinical improvement; it was not associated with statistically significant differences in haematological variables. CONCLUSION AND CLINICAL IMPORTANCE This study suggests that Tregs may be involved in the pathogenesis of CAD and that ciclosporin therapy does not affect the circulating lymphocyte subpopulations.

Cytologic and immunocytochemical characterization of feline progressive histiocytosis.

BACKGROUND Feline Progressive Histiocytosis (FPH) is a cutaneous dendritic cell neoplasm characterized by slow progression and spread to internal organs in the terminal stage. FPH is often misdiagnosed as an inflammatory reaction and has not been fully characterized from a cytologic diagnostic perspective. OBJECTIVES The purpose of the study was to characterize the cytologic and immunocytochemical aspects useful for FPH diagnosis. METHODS Fine-needle aspiration cytologic samples of 5 cases of FPH confirmed by skin biopsy and necropsy were evaluated. Immunocytochemistry with antibodies recognizing CD1a, CD1c, CD3, CD11b, CD18, CD21, and MHCII was performed on air-dried, acetone-fixed smears. E-cadherin expression was assessed on paraffin-embedded skin biopsies. Transmission electron microscopy (TEM) was performed in one case. RESULTS Main cytologic findings on variably cellular samples were characterized by single to cohesive large, round to polygonal cells with intermediate to low N/C ratio, abundant clear homogeneous cytoplasm, and round to oval nuclei with rare bi- to multinucleated atypical cells, associated with low numbers of small lymphocytes and/or neutrophils. Neoplastic cells expressed CD1a, CD1c, CD11b, CD18, and MHCII. Anti-CD3 antibodies identified reactive T cells admixed with the neoplastic cells. E-cadherin expression was observed in all but one case. TEM failed to identify Birbeck granules in one case. CONCLUSIONS FPH is a distinctive neoplastic lesion composed of nonphagocytizing histiocytes variably admixed with neutrophils and small mature lymphocytes. Immunocytochemical analysis with CD1 is mandatory to confirm a dendritic cell origin. Immunocytochemistry and cytomorphology allowed the specific and rapid diagnosis of FPH on cytologic samples.

Feline trombiculosis: a retrospective study in 72 cats

BACKGROUND Trombiculosis is the infestation of a host by the larval form of mites belonging to the Trombiculidae family. Few data are available regarding this infestation in cats. HYPOTHESIS/OBJECTIVES The aim of this retrospective study was to report data, clinical signs, diagnostic and therapeutic features of feline trombiculosis. METHODS Clinical records of cats presented for dermatological examination or annual vaccination in Italy, from 2002 to 2012, were retrospectively searched using the key words trombiculosis, cat and Neotrombicula. RESULTS Seventy-two indoor/outdoor domestic short-hair cats with infestation by Neotrombicula autumnalis were enrolled. Pruritus was reported by the owners in 43% of cases, while 57% of cats were asymptomatic. The most common clinical signs included sudden onset of pruritus and the appearance of orange-coloured granules on the skin. Mites were found incidentally in 12 cats. The larvae were localized in multiple sites in 68% of cases. The most frequently affected area was the ear (80.5% of cases). Mites were more often identified in autumn (41 cases). Eleven cats were diagnosed during winter, 13 in spring and seven in summer. CONCLUSIONS AND CLINICAL IMPORTANCE This retrospective study suggests that feline trombiculosis is probably underestimated as a cause of pruritus and dermatological lesions. Epidemiological data regarding this infestation in cats are still lacking, and it will be interesting to perform a multicentre study to increase knowledge of this disease.

Randomized, double‐blinded, placebo‐controlled pilot study on the effects of topical blackcurrant emulsion enriched in essential fatty acids, ceramides and 18‐beta glycyrrhetinic acid on clinical signs and skin barrier function in dogs with atopic dermatitis

BACKGROUND Lipid-based emulsions can be useful for the management of canine atopic dermatitis (cAD). 18-beta glycyrrhetinic acid (GRA), a component of liquorice root, has anti-inflammatory and anti-pruritic effects. HYPOTHESIS/OBJECTIVES To evaluate the effects of a topical lipid emulsion containing ceramides, fatty acids and GRA on clinical signs of cAD and skin barrier in a randomized, double-blinded, placebo-controlled trial. METHODS Client owned (n = 45) dogs with nonseasonal, mild/moderate AD, received either treatment or placebo for three months. Skin lesions, pruritus, transepidermal water loss (TEWL) and global assessment (GA) were evaluated. RESULTS Fourteen dogs receiving treatment and 14 receiving the placebo completed the study. After one month ≥50% reduction in pruritus was seen in seven of 14 dogs (50%) in the Treatment group, and in two of 14 dogs (14.3%) in the Control group (P = 0.047). After two and three months, significant reduction in pruritus was not seen. For Canine Atopic Dermatitis Extent and Severity Index (CADESI), TEWL and GA, there were no significant findings over time or between groups. CONCLUSIONS AND CLINICAL RELEVANCE The emulsion had some transient beneficial clinical effects. However, it was not effective in controlling pruritus as a monotherapy. Further studies should examine whether owner compliance was a factor in the steady decline of effect on pruritus scores. Further studies evaluating its role as an adjunctive therapy are indicated.

Sublingual Reactive Histiocytosis in a Dog

Lingual lesions are relatively uncommon in dogs and are mostly represented by neoplasms and glossitis secondary to trauma or infections. Reactive histiocytosis is an uncommon, poorly understood, reactive disorder characterized by proliferation of activated, interstitial, dendritic, antigen-presenting cells associated with lymphocytes and neutrophils with a specific angiocentric orientation and occasional angioinvasion and angiodestruction. Clinically, the disease has a waxing and waning behavior with possible response to treatment and regression, or progression to multiple lesions and internal organ involvement. This case report describes an unusual sublingual presentation of reactive histiocytosis in a Miniature Pinscher dog. The diagnosis was obtained by clinical and histopathological exclusion of other causes, detection of the characteristic microscopic growth pattern, and by immunocytochemistry. Histiocytic cells were vimentin, CD18, CD11c, and CD1c positive consistent with a dendritic cell origin. Anti-BCG stain (Bacillus Calmette and Guerin) was negative for etiological agents. The dog was treated with oral administration of tetracycline and niacinamide during an 8-month period. There was no indication of recurrence of the sublingual mass 2-years following treatment.