Efficacy of itraconazole in 18 cases of Malassezia dermatitis in dogs

개에서 Malassezia 피부염에 대한 itraconazole 치료 18례

  • Jeong A-young (Department of Veterinary Internal Medicine & Dermatology, College of Veterinary Medicine, Kyungpook National University) ;
  • Hoh Woo-phil (Department of Veterinary Internal Medicine & Dermatology, College of Veterinary Medicine, Kyungpook National University) ;
  • Jeong Hyo-hoon (Department of Veterinary Internal Medicine & Dermatology, College of Veterinary Medicine, Kyungpook National University) ;
  • Eom Ki-dong (Department of Veterinary Radiology, College of Veterinary Medicine, Kyungpook National University) ;
  • Lee Keun-woo (Department of Veterinary Internal Medicine & Dermatology, College of Veterinary Medicine, Kyungpook National University) ;
  • Oh Tae-ho (Department of Veterinary Internal Medicine & Dermatology, College of Veterinary Medicine, Kyungpook National University)
  • Published : 2005.06.01

Abstract

Itraconazole was found to be an effective antifungal for the treatment of canine Malassezia dermatitis (MD). MD was diagnosed in 18 dogs, which were treated with itraconazole administered orally at 5 mg/kg of body weight, q12hrs, for 21 to 30 days. High prevalence breeds of MD were Maltese $(22\%)$, Cocker Spaniel $(17\%)$, Pekingese $(11\%)$, and Vizsla $(11\%)$. The dermatological signs of Malassezia dermatitis were crust $(31\%)$, alopecia $(25\%)$, hyperpigmentation $(25\%)$, scales$(19\%)$, erythema $(13\%)$, lichenification $(11\%)$, pustule $(11\%)$, ear swelling$(11\%)$, papules $(5\%)$, and offensive odor $(5\%)$. Commonly affected areas were ear canal $(41\%)$, axillae $(18\%)$, groin $(15\%)$, perianal $(12\%)$, ventral aspect of the neck $(9\%)$, interdigital spaces$(1\%)$, and muzzle $(1\%)$. Sixty seven percent of dogs with MD had cocci. Clinical responses of itraconazole were seen good, moderate, no responses of itraconazole, in $89\%,\;0\%,\;and\;11\%$, respectively, according to the owner's satisfaction to follow up call. Recurrence was detected on five good responsive dogs and adverse effects of the treatment were detected in only one dog. On the basis of this clinical study, itraconazole is a good choice in the treatment of canine Malassezia dermatitis. Efficacy, frequency of administration and veterinary approval are the major advantages.

Malassezia 피부염으로 진단된 18두의 개를 대상으로 Itraconazole 5mg/kg을 1일 2회 경구 투여하여 치료효과를 알아보았다 치료반응을 보인 환자는 $88\%$이었으며 소양감과 피부병면은 치료후 1주일에 확연히 개선되었다. 치료대상견의 품종은 Haltese$(22\%)$, Cocker Sptuiel$(17\%)$, Pekingese$(11\%)$, Vizsla$(11\%)$이었다. 피부증상으로는 가피$(31\%)$, 탈모$(25\%)$, 색소침착$(25\%)$, 인설$(19\%)$, 발적$(13\%)$, 태선화$(11\%)$, 농포$(11\%)$ 귀부종$(11\%)$, 구진$(5\%)$의 순으로 냐타났다. 병변발생부위는 이도$(41\%)$, 액와부$(18\%)$, 서혜부$(15\%)$, 회음부$(12\%)$, 복측경부$(9\%)$, 지간부$(1\%)$, 총구부$(1\%)$ 이었다. 세포학적 검사시$61\%$의 환견에서 구균이 동시에 검출되었다. Itraconazole에 대한 임상반응은 $89\%$가 치료반응을 보였고 (2두)$11\%$는 치료반응을 보이지 않았다 치료반응을 보인 환자 중 5두는 재발되었고 1두는 갑상선 기능저하증이었으며 나머지 4두는 재발의 원인을 확인할 수 없었다. 1두에서 투여 후 28일에 식욕결집, 침울의 증상이 발현되어 투약을 중지하였다. 따라서itraconazole을 5mg/kg을 1일 2회 경구투여는 Malassezia 피부염에 효과적인 치료로 사료된다

Keywords

References

  1. Bond R, Collin NS, Lloyd DH. Use of contact plates for the quantitative culture of Malassezia pachydermatis from canine skin. J Small Anim Pract 1994; 35: 66-72
  2. Bond R, Rose JW, Lloyd DH. Comparioson of two shampoos for tretment of Malassezia pachydermatis-associated seborrhoeic dermatitis in basset hounds. Journal of Small Animal Practice 1995; 36: 99-104 https://doi.org/10.1111/j.1748-5827.1995.tb02840.x
  3. Evans AG. Difficult dermatologic diagnosis. J Am Vet Med Assoc 1991; 198: 1141-1142
  4. Gupta AK, Kohli Y, Li A, Faergemann J, Summerbell RC. In itro susceptibility of the sevenn Malassezia species to Ketoconazole, voriconazole and terbinatine. Br J Derm 2000; 142: 758-765 https://doi.org/10.1046/j.1365-2133.2000.03294.x
  5. Lee JH, Oh TH, Han HR, Cho SN. Immune reaction to infection by Malassezia pachydermatis in canine external ear canals. Kor J Vet Clin Med 1996; 13: 130-139
  6. Legendre AM. Atimycotic drug therapy. In: Current Veterinary Therapy, 12th ed. Philadelphia: WB Saunders. 1995: 327-331
  7. Manson KV, Kirk RW, Bonagur JD. Malassezia dermatitis and otitis. In: Current Veterinary Therapy XI. Philadelphia: WB Saunders. 1992: 544-546
  8. Mnson KV, Griffin CE, Kwochka KW, MacDonald JM. Cutaneous Malassezia. In: Current Veterinary Dermatology. St Louis; Mosby-Year Book. 1993: 44-48
  9. Manson KV, Stewart LJ, Ihrke PJ, Manson IS, White SD. Malassezia and canine dermatitis. Advances in Veterinary Dematology. New York: Pergamon Press. 1993; 1: 399-402
  10. Martin MV. The use of fluconazole and itraconazole in the treatment of Candida albicans infections:a review. J Antimicrob Chemother 1999; 44: 429-437 https://doi.org/10.1093/jac/44.4.429
  11. Matousek JL, Cambell KL. Malassezia Dermatitis. Compend Contin Educ Pract Vet 2002; 24: 224-231
  12. Mauldin EA, Scott DW, Miller WH, Smith CA. Malassezia dermatitis in the dog: a retrospective histopathological and immunopathological study of 86 cases (1990-95). Vet Dermatol 1997; 8: 191-202 https://doi.org/10.1046/j.1365-3164.1997.d01-15.x
  13. Morris DO. Malassezia Dermatitis and Otitis. Vet Clin North Am Samll Anim Pract 1999; 29: 1303-1310
  14. Morris DO. Type-l hypersensitivity rections to Malassezia pachydermatis extracts in atopic dogs. Am J Vet Res 1998; 59: 836-841
  15. Parry ME, Sharpe GR. Seborrheic dermatitis is not caused by an altered immune response to Malassezia yeast. Br J Derm 1998; 139: 254-263 https://doi.org/10.1046/j.1365-2133.1998.02362.x
  16. Pinchbeck LR, Hiller A, Kowalski JJ, Kwochka KW. Comparison of pulse administration versus once daily administration of itraconazole for the treatment of Malassezia pachydermatis dermatitis and otitis in dogs. J Am Vet Med Assoc 2002; 220: 1807-1812 https://doi.org/10.2460/javma.2002.220.1807
  17. Pland JD, Rosenkrants WS, Griffin CE. Factors associated with and prevalence of high Malassezia pachydermatis numbers on dog skin. J Am Vet Med Assoc 1992; 201: 879-882
  18. Russell M. Malassezia Dermatitis. In: Current Veterinary Therapy XIII. Philadelphia: W.B. Saunders. 1999: 574-577
  19. Scott DW, Miller WH, Griffin CE. Malassezia dermatitis. In: Small Animal Dermatology, 6th ed. Philadelphia: WB Saunders. 2001: 363-374
  20. Scott DW, Miller WH, Griffin CE. Antifungal therapy. In: Small Animal Dermatology, 6th ed. Philadelphia: WB Saunders. 2001: 409-415
  21. Scott DW, Miller WH, Griffin CE. Otitis externa. In: Small Animal Dermatology, 6th ed. Philadelphia: WB Saunders. 2001: 1204-1230
  22. Terui T, Rokugo M, Kato T. Analysis of the proin-flammatory property of epidermal cyst contents:chemotactic C5a anaphylatoxin generation. Arch Dermatol Res 1989; 281: 31-34 https://doi.org/10.1007/BF00424269