Introduction

• Skin disease can be treated topically and/or systemically. The choice between topical and systemic therapy, or a combination of these modalities, is usually dependent on the diagnosis. For example, topical treatment may be the preferred route for surface-dwelling ectoparasite infestations (Neotrombicula, Otodectes, Cheyletiella spp), for surface and ideally superficial pyoderma and uncomplicated focal/regional inflammation. On the other hand, additional systemic therapy is necessary for deep pyoderma Skin: deep pyoderma and for generalized inflammation as in atopic dermatitis Skin: atopy. 
• Topical and systemic therapy may be combined, such as in the treatment of flea allergic dermatitis Skin: flea bite hypersensitivity, superficial bacterial pyoderma or generalized demodicosis. 
• Agents used in the treatment of skin disease include barrier function therapies, anti-allergic or anti-inflammatory drugs, eg glucocorticoids Therapeutics: glucocorticoids, antimicrobials Therapeutics: antimicrobial drug (antibacterials, antifungals), antiparasitics Therapeutics: parasiticide, immunomodulators Therapeutics: immunological preparation, immunosuppressants, chemotherapeutics and more targeted antipruritics. 
• Barrier methods can useful, with very pruritic, self-traumatizing dogs, whilst awaiting for medication to take effect - although the onset of action of some anti-inflammatory / antipruritic medications can be rapid.

Dermatological vehicles

Collars

Topical medications - modes of treatment

Topical medications - therapeutic applications

Systemic medications - modes of treatment

Systemic medications - therapeutic applications

Systemic medication - less common therapeutic applications

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.

Key references 

• Mueller R S, Rosenkrantz W, Besignor E, Karas-Tecza J, Paterson T, Shipstone M A (2020) Diagnosis and Treatment of demodicosis in dogs and cats (Clinical Consensus Guidelines of the World Association of Veterinary Dermatology). Vet Dermatol 31 (1), 4-26 PubMed.
• Bond R, Daniel O, Morris D O, Guillot J, Mason K S, Kano R, Hill P B (2020) Biology, diagnosis and treatment of Malassezia dermatitis in dogs and cats Clinical Consensus Guidelines of the World Association for Veterinary Dermatology (Clinical consensus guidelines of the World Association of Veterinary Dermatology). Vet Dermatol 31(1), 27-72 PubMed.  
• Moriello K A,  Coyner K, Paterson S & Mignon B (2017) Diagnosis and treatment of dermatophytosis in dogs and cats. (Clinical Consensus Guidelines of World Association for Veterinary Dermatology). Vet Dermatol 28 (3),266-e68 PubMed.
• Morris D O, Loeffler A, Davis M F, Guardabassi L, Scott Weese J (2017) Recommendations for approaches to meticillin‐resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures (Clinical Consensus Guidelines of World Association for Veterinary Dermatology). Vet Dermatol 28 (3), 304-e69 PubMed.
• Olivry T, De Boer D J, Favrot C, Jackson H, Mueller R S, Nuttall T, Prelaud P (2015) Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet Res 11, 210 PubMed.
• Hillier A, Lloyd D H, Weese J S, Blondeau J M, Boothe D, Breitschwerdt E et al (2014) Guidelines for the diagnosis and antimicrobial therapy of canine superficial bacterial folliculitis (Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases). Vet Dermatol 25 (3), 163-175 e42-3 PubMed.
• ​Beco L, Guaguère E, Lorente Méndez C, Noli C, Nuttall T, Vroom M (2013) Suggested guidelines for using systemic antimicrobials in bacterial skin infections. Vet Rec 172 (3),72-78 PubMed & 172(6), 156-160 PubMed. 

Other references  

• Levy B J, Linder K E, Olivry T (2019) The role of oclacitinib in the management of ischaemic dermatopathy in four dogs. Vet Dermatol 30 (3), 201-e63 PubMed.
• Olivry T, Banovic F (2019) Treatment of canine atopic dermatitis: time to revise our strategy? Vet Dermatol 30 (2), 87-90 PubMed.
• Chan C M, Frimberger A E, Moore A S (2018) Clinical outcome and prognosis of dogs with histopathological feaures consistent with epitheliotropic lymphoma: a retrospective study of 148 cases (2003-2015). Vet Dermatol 29 (2), 154-e59 PubMed.
• Souza C P, Rosychuk R A W, Contrera E T, Schissler J R, Simpson A C (2018) A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA. Vet Dermatol 29(6), 489-e164 PubMed.
• Bizikova P, Olivry T (2015) Oral glucocorticoid pulse therapy for induction of treatment of canine pemphigus foliaceus – a comparative study. Vet Dermatol 26 (5), 354 -e77 PubMed.
• Fourie J J, Liebenberg J E, Horak I G, Taenzler J, Heckeroth A R, Frenais R (2015) Efficacy of orally administered fluralaner (Bravecto®) or topically applied imidacloprid/moxidectin (Advocate®) against generalized demodicosis in dogs. Parasites and Vectors 8, 187 PubMed. 
• Little P R, King V L, Davis K R, Cosgrove S B, Stegemann M R (2015) A blinded, randomized clinical trial comparing the efficacy and safety of oclacitinib and ciclosporin for the control of atopic dermatitis in client-owned dogs. Vet Dermatol 26 (1), 23-30, e7-8 PubMed. 
• Noli C, della Valle M F, Miolo A, Medori C, Schievano C (The Skinalia Clinical Research Group) (2015) Efficacy of ultra‐micronized palmitoylethanolamide in canine atopic dermatitis: an open‐label multi‐centre study. Vet Dermatol 26, 432-440; e101 PubMed.
• White S D, Bourdeau P, Rosychuk R A W, Cohen B, Bonenbuger T et al (2001) Zinc-responsive dermatosis in dogs: 41 cases and literature review. Vet Dermatol 12, 101-109 PubMed.

Other sources of information 

• Proceedings of the ESVD Therapeutics Workshop, Davos, Switzerland (2018). 
• Proceedings of the British Veterinary Dermatology Study Group: www.bvdsg.org.uk/ accessed 29.04.2020. 
• Solano-Galego L, Miro G, Koutinas A, Cardoso L, Pennisi M G, Ferrer L, Bourdeau P, Oliva G., Baneth G (2015) Leishvet guidelines for the practical management of canine & feline leishmaniosis. http://www.leishvet.org/ accessed 29.04.2020.
• Miller W H, Griffin C E, Campbell K L (2013) Muller & Kirk's Small Animal Dermatology. 7th edition. Saunders, Philadelphia. 
• Patel A (2013) Sebaceous adenitis in dogs. Comp Animal 18 (3), 120-124.