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Diagnosis of atopy

Diagnosis of atopy

It is extremely important in the diagnostics of atopic dermatitis to have a systematically prepared clinical history, as well as to adequately record all of the information obtained during the entire process of the examination.

The following aspects are important in the clinical history:

  • Age at which symptoms first developed: the first symptoms occur as early as between the age 1-3 years in 75% of the atopy patients Sporadically, symptoms occur in animals under 6 months of age. The initial symptoms are often ignored by the owner because of a quick response on following medication, a spontaneous recovery with the changing of the seasons or a change in the environmental factors.
  • Breed predisposition: atopic dermatitis is observed more than average in Ihasa Apso, Schnauzers, Poodles, Terriers (West Highland White, Cairn, Jack Russell and Fox terrier), Dalmatian, German Shepherd, Boxer and Retriever (Golden, Labrador)1.
  • Season-related: initial the symptoms of a pollen allergy are usually season-related.. However, the longer the atopy continues, the more the symptoms can manifest themselves throughout the year. Allergens such as house dust mite and cat epithelium, on the other hand, may cause atopic dermatitis throughout the year.

The anamnesis should also include questions regarding the sleeping place (floor covering, pillows, blankets etcetera, in connection with contact dermatitis), the food (food allergy), the presence of other animals (atopy based on animal epithelium) and the vegetation in and around the house. The effect of previously imposed treatments may also produce valuable information.

1 Sousa, et al. Vet Immunol. Path. 81 (2001) 153-157

Additional diagnostic tests

Skin scrapings microscopic tests, fungal and bacterial cultures must be conducted in order to exclude any ecto-parasitic and infectious causes of the skin problems.
An elimination diet (hypo-allergenic diet, possibly followed by a provocation (challenge) diet, can provide information regarding the likeliness of a food allergy.

Differential diagnosis

Important differential diagnostics for atopic dermatitis are: demodicosis, dermatophytosis, food allergy, idiopathic pododermatitis and trombiculosis (trombiculid mites). If these tests are negative excluded, the probable diagnosis is atopic dermatitis, the next step is to perform an allergy test.