Updates on the Pathogenesis of Canine Atopic Dermatitis and Feline Atopic Skin Syndrome: Part 2, the Skin Barrier, the Microbiome, and Immune System Dysfunction

In affected individuals, the maintenance of a healthy skin barrier with limited microbial dysbiosis by topical antiseptics and moisturizing therapy should be prioritized. Systemic and local cutaneous immune dysregulation leading to inflammatory skin disease should be controlled using species and age-appropriate systemic and topical immunomodulatory therapies. Given that allergens may wax and wane over the course of the year or the patient's lifetime, veterinarians and pet owners will need to expect flares of disease that require stabilization of the skin barrier, microbiome, and pro- inflammatory state.