Flea allergy dermatitis (FAD) is the most common veterinary
dermatologic condition in the
world. It begins with the bite of a flea. The saliva of the flea
contains amino acids, aromatic
compounds, fluorescent
materials, polypeptides, and
phosphorus. (9) In the dog the
antigenic substances carry a
molecular weight of 18,000 to
45,000 daltons with the major
allergen of MW 30,000 to
32,000 daltons. (10) The main thing
that dog owners notice is
scratching, chewing, licking,
biting, and other signs of pruritus.
Sixty one percent of flea allergic
dogs develop clinical signs
between 1 and 3 years of age. (11)
As animals age, with continued
exposure to fleas, the degree of
hypersensitivity may wane. FAD
is uncommon in dogs less than 6
months of age. Patients usually
have papules, crusts, salivary
stains, excoriations, and
erythema in a wedge-shaped
pattern over the lumbosacral
region, caudal thighs, proximal
tail, ventral abdomen, and around
the umbilicus. With chronic itching
the areas become alopecic,
lichenified, and hyperpigmented
and the dog will develop an odor
related to secondary infections
with Staphylococcus
intermedius and Malassezia
pachydermatis.
A diagnosis of FAD is based on
the age of onset of the pruritus,
the distribution of the pruritus and
clinical signs, and the observation
of fleas and/or flea feces. Many
dogs who are allergic to the bite
of a flea have very few fleas on
them at any time because their
excessive grooming activity
removes the fleas. Some of those
patients will have recurrent
tapeworm (Diplydium
caninum) infestations from
ingestion of the fleas. The
diagnosis of FAD can be
confirmed with an intradermal
skin test with flea antigen.