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tvpjournal.com | January/February 2016 | Today's VeTerinary PracTice 75 DERMATOLOGY DETAILS Peer Reviewed defnable cause. in such cases, initial treatment has often centered on long-acting injectable glucocorticoids, such as methylprednisolone acetate. When the disease is idiopathic and recurrent, problems arise when: 1. each glucocorticoid injection makes development of diabetes mellitus more likely or 2. The disease is, or becomes, glucocorticoid resistant. other treatment protocols include those based on: • Cyclosporine: May need to be used at doses up to 13.3 mg/kg Po Q 24 H 12 or • Chlorambucil: 0.1–0.2 mg/kg Po Q 24 H or Q 48 H. 13 exercise caution with these protocols: this dose of cyclosporine is nearly twice the feline label dose of 7 mg/kg, and possibility of adverse effects is increased, while chlorambucil is a potent and potentially myelosuppressive drug. Monitoring cyclosporine levels and complete blood counts may be advisable in some cases. The treatments outlined are not always effective, however, and it appears that this dilemma may persist for some time to come. ad = atopic dermatitis; ige = immunoglobulin e; Mrs = methicillin-resistant Staphylococcus ; Mrsa = methicillin-resistant Staphylococcus aureus ; MrsP = methicillin-resistant Staphylococcus pseudintermedius ; Mrss = methicillin-resistant Staphylococcus schleiferi References 1. Jones rd, Kania sa, rohrbach BW, et al. Prevalence of oxacillin- and multidrug-resistant staphylococci in clinical samples from dogs: 1,772 samples (2001-2005). JAVMA 2007; 230:221-227. 2. Borio s, colombo s, La rosa G, et al. effectiveness of a combined (4% chlorhexidine digluconate shampoo and solution) protocol in Mrs and non-Mrs canine superfcial pyoderma: a randomized, blinded, antibiotic-controlled study. Vet Dermatol 2015; doi: 10.1111/vde.12233. 3. clark sM, Loeffer a, Bond r. susceptibility in vitro of canine methicillin-resistant and -susceptible staphylococcal isolates to fusidic acid, chlorhexidine and miconazole: opportunities for topical therapy of canine superfcial pyoderma. Vet Rec 2013; 172(6):156-160. 4. Beco L, Guaguere e, Mendez L, et al. suggested guidelines for using systemic antimicrobials in bacterial skin infections: Part 2—antimicrobial choice, treatment regimens and compliance. Vet Rec 2013; 172:156-160. 5. Hillier a, Lloyd dH, Weese Js, et al. Guidelines for the diagnosis and antimicrobial therapy of canine superfcial bacterial folliculitis (antimicrobial Guidelines Working Group of the international society for companion animal infectious diseases). Vet Dermatol 2014; 25:163-175, e42-e43. 6. Halliwell r. revised nomenclature for veterinary allergy. Vet Immunol Immunopathol 2006; 114:207-208. 7. Favrot c, steffan J, seewald W, et al. a prospective study on the clinical features of chronic canine atopic dermatitis and its diagnosis. Vet Dermatol 2010; 21:23-31. 8. Hensel P, santoro d, Favrot c, et al. canine atopic dermatitis: detailed guidelines for diagnosis and allergen identifcation. BMC Vet Res 2015; 11:196. 9. olivry T, deBoer dJ, Favrot c, et al. Treatment of canine atopic dermatitis: 2015 updated guidelines from the international committee on allergic diseases of animals (icada). BMC Vet Res 2015; 11:210. 10. okuma Ta, Hellberg rs. identifcation of meat species in pet foods using a real-time polymerase chain reaction (P cr) assay. Food Control 2015; 50:9-17. 11. Fourie JJ, Liebenberg Je, Horak iG, et al. effcacy of orally administered furalaner (Bravecto) or topically-applied imidacloprid/moxidectin (advantage) against generalized demodicosis in dogs. Parasites Vectors 2015; 8:187. 12. Vercelli a, raviri G, cornegliani L. The use of oral cyclosporin to treat feline dermatoses: a retrospective analysis of 23 cases. Vet Dermatol 2006; 17:201-206. 13. Buckley L, nuttall T. Feline eosinophilic granuloma complex(ities): s ome clinical clarifcation. J Feline Med Surg 2012; 14:471-481. FIGURE 4. Eosinophilic granuloma disease (in this case, collagenolytic or "linear" granuloma) in a young cat. Although this pattern is usually thought to be a reaction to a parasite or allergen, some cases are idiopathic and may be treatment resistant. Douglas J. DeBoer Douglas J. DeBoer, DVM, Diplomate ACVD, is a professor of dermatology at University of Wisconsin—Madison School of Veterinary Medicine. Dr. DeBoer received his DVM at University of California—Davis and completed postgraduate training at Michigan State University and at University of California—Davis. Dr. DeBoer is a frequent lecturer at national and international continuing education courses for graduate veterinarians. His research and clinical interests include the immunology of recurrent and chronic skin diseases, with a focus on canine allergic skin disease. To learn more about the dermatologic conditions discussed in this article, read the following articles available at tvpjournal.com: • What is New in the Diagnosis and Management of Canine Atopic Dermatitis? (May/ June 2015) • Treating Resistant Skin Infections in Dogs (May/June 2014) • Feline Dermatology: Cats Are Not Small Dogs (November/ December 2013) • My 6-Step Plan for Diagnosing & Managing the Pruritic Dog (July/ August 2013) • Methicillin-Resistant Staphylococcal Infections: Recent Developments (May/June 2013) • Challenges & New Developments in Canine Pyoderma: Disease Overview & Diagnosis (January/ February 2012) and Topical & Systemic Treatment (March/ April 2012)