درمان های نوین درماتیت آتوپیک سگها
محورهای موضوعی : عوارض درمانگاهی منجر به ایجاد بیماری ها و درمان
1 - گروه علوم درمانگاهی، دانشکده دامپزشکی، دانشگاه فردوسی مشهد، مشهد، ایران.
کلید واژه: آتوپی, درماتیت آتوپیک, درماتیت آلرژیک, سگ, خارش,
چکیده مقاله :
درماتیت آتوپیک یک بیماری پوستی شایعِ خارشدار و التهابی با زمینهی ژنتیکی و دارای تظاهرات باليني خاص است. پژوهش حاضر با هدف ارتقا دانش و یکپارچه سازی روشهای درمانی دامپزشکان حیوانات خانگی در ایران صورت گرفته است. پژوهش حاضر به صورت مروری (Review) و بر پایه آخرین به روز رسانی دستورالعمل درمان درماتیت آتوپیک سگها (زیر نظر کارگروه بیماریهای آلرژیک حیوانات) و جمع بندی پژوهشهای نگارنده در ده سال گذشته صورت گرفته است. درمان حمله های حاد درماتیت آتوپیک سگها سه بخش دارد؛ 1- شناسایی و حذف علل ایجاد و / یا عوامل آلرژی زای تشدید کننده مانند گرده افشانی گیاهان، جرب گرد و غبار (درماتوفاگوئیدس)، پایودرم و درماتیت مالاسزیایی 2- درمان ضدمیکروبی و ارتقای بهبود بهداشت و سلامت پوست و مو مانند تجویز شستشو با یک شامپوی غیرتحریک کننده و ملایم 3-کاهش شدت خارش و و ضایعات پوستی با داروها مانند درمان کوتاه مدت با گلوکوکورتیکوئیدهای موضعی یا خوراکی یا اُکلاسیتینیب یا اینترفرونهای نوترکیب تزریقی 4- پیشگیری از عود بیماری با ایمنی درمانی توسط آلرژنهای اختصاصی و تجویز پیشگیرانهی گلوکوکورتیکوئیدهای موضعی درمانهایی که تاکنون فاقد کارایی بوده اند: 1- هیچ شاهد قطعی برای اثبات کارایی آنتی هیستامینها در درمان درماتیت آتوپیک فعال در سگها وجود ندارد. 2- تجویز اسیدهای چرب ضروری خوراکی به دلیل طولانی بودن زمان لازم برای هرگونه اثربخشی مؤثر آنها، در درمان التهابهای حاد درماتیت آتوپیک مفید نیست. درمان حملههای حاد درماتیت آتوپیک چندوجهی است و برای دستیابی قطعي يا احتمالي به اثر درماني بهينه، باید مداخلات درمانی ترکیب شوند. لازم است پيش از طراحي يك برنامهي درماني، كيفيت زندگي سگها و صاحبانشان و نيز ترجيح نظر صاحب حيوان، در نظر گرفته شود.
Atopic dermatitis is a common pruritic and inflammatory dermatosis with genetic background and specific clinical manifestations. The present study was carried out with the aim of improving the knowledge and integration of the treatment protocols of veterinarians in Iran. The current research is a review based on the based on the task force for the treatment of canine atopic dermatitis (International Committee of Allergic Diseases of Animals) and a summary of the author's researches in the field of dermatology. The treatment of acute flares of canine atopic dermatitis should involve three parts; 1- To search for and then to eliminate the causes and/or aggravating allergens such as plant pollen allergens, house dust mites (dermatophagoides), pyoderma and/or Malassezia dermatitis. 2- Antimicrobial treatment and improvement of skin and hair health, such as bathing with mild shampoos. 3- To control pruritus and skin lesions with interventions that include topical and oral glucocorticoids, oral Oclacitinib, and injectable recombinant interferons. 4- Immunotherapy using specific allergens and prophylactic administration of topical glucocorticoids are the only interventions that may prevent or delay the recurrence of dermatitis. There is no conclusive evidence to prove the efficacy of: 1- Antihistamines in the treatment of atopic dermatitis in dogs 2- Administration of oral essential fatty acids due to the long time required for any effective effect. The treatment of acute flares of atopic dermatitis is multifaceted, and in order to achieve the optimal therapeutic effect, therapeutic interventions must be combined. Before designing a treatment plan, it is necessary to consider the quality of life of dogs and their owners, as well as the preference of the owner's opinion.
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