Treatment options for mild atopic dermatitis

Atopic dermatitis can have multiple causes, with one particular allergy—and the most common one—having the ability to cause year-round issues. In this interview about his lecture on atopic dermatitis, presented at the 2025 Veterinary Meeting & Expo, Jason B. Pieper, DVM, MS, DACVD, assistant professor at Iowa State University, talks about the top cause for atopic dermatitis, as well as some of the other causes for this condition. Pieper also delves into the various treatment options for mild atopic dermatitis.

Below is a partial transcript which has been lightly edited for clarity:

Jason B. Pieper, DVM, MS, DACVD: …It is tough when we talk about atopic dermatitis, I mean, there's a variety [of causes]. [The patient] can be allergic to, grasses, trees, weeds, molds as well.

The number one, actual one, though, is house dust mites, which is very similar to humans. So usually with them then it's a year-round problem. You know, it's not just a seasonal issue. It's a year-round [issue] and even for dogs that are mildly allergic when they're younger, as they get older, they tend to still develop allergies to house dust mites, so then they have [those] year-round kind of clinical signs, but that's definitely been the most common allergy that we find for atopic dermatitis.

When you sit there and kind of classify them on their clinical lesions, I guess usually, I base it on what we call this PVAS, or the Pruritus Visual Analog [Scale], and it’s zero to 10. Zero is not really doing anything; 10 is itching all the time, you know, uncontrollable, not even able to stop to eat. They have stopped that and will start itching. And so when I say there's a dog [that is] a 3 to 4 out of 10, that's where it’s considered mild disease. And you know, usually, then we're talking about adjunctive therapies, is the way I think of it.