Integrating nutrition with therapy: Role of skora-33 in managing Malassezia dermatitis in dog- a case report

Introduction

Malassezia are lipophilic commensal yeasts of the skin and mucosa of dogs (Bajwa, 2023) [1] , particularly those between one and eight years of age, as noted by Bardshiri et al. (2014) [2] . Certain breeds, such as West Highland White Terriers, English Setters, Shih Tzu's, Basset Hounds, American Cocker Spaniels, Boxers, Dachshunds, Poodles, and Australian Silky Terriers are considered more susceptible to this condition (Hobi et al., 2022; Bajwa, 2023) [5,1] . There is no clear gender or age predisposition (Bond et al., 2020) [3] . M. pachydermatis is the predominant species in the healthy skin of dogs, Malassezia typically cause superficial dermatitis, otitis externa and/ or paronychia (Bond et al., 2020; Guillot and Bond, 2020; Hobi et al., 2022; Bajwa, 2023) [3,4,5,1] . In dogs, this occurs secondary to ectoparasites, allergies (flea bite hypersensitivity, food-induced and environmentally induced atopic dermatitis), endocrinopathies (hyperadrenocorticism, hypothyroidism, diabetes mellitus), superficial pyoderma, keratinization disorders or rarely autoimmune diseases. These diseases alter the environment of the yeasts in a favourable way (Bond et al., 2020) [3] . Malassezia dermatitis can be localized or generalized. Dermatological signs include alopecia, erythema, scales, crusts, greasiness and in more chronic cases, hyperpigmentation and lichenification (Bond et al., 2020) [3] . Malassezia can proliferate within the stratum corneum, the outermost layer of the epidermis, leading to the accumulation of various metabolites and allergens. Epidermal Langerhans cells and keratinocytes recognize Malassezia antigens leading to the formation of antimicrobial peptides and specific cytokines resulting in either a "neutral" commensal state (Il-10, TGF-β) or an inflammatory response (Il-1, Il-6, Il-8, TNFα) (Ruth Ashbee, 2006; Bond et al., 2020) [9,3] . Managing Malassezia dermatitis requires both treating yeast overgrowth with antifungal drugs and addressing underlying causes. In addition to medications, non-drug approaches can help improve skin health and reduce symptoms (Marchegiani et al., 2020) [6] . SKORA-33 is a plant-based supplement containing fatty acids, antioxidants, vitamins, and minerals to support skin and hair health in pets. It helps maintain skin strength and elasticity, protects against damage, reduces itching, and supports healthy hair growth.

Materials and Methods

A non-descript male dog weighing 10kg of 5 year old presented to Bark India Charitable Trust, Villupuram with history and clinical signs of alopecia, erythema, crusts and hyperpigmentation, which was tentatively diagnosed as Malassezia dermatitis. After a detailed history, physical, and dermatological examination, followed by collection of samples for cytological examination was obtained. Cotton swabs rubbed on the affected sites were used for cytological studies. Blood (5 ml) was collected for the determination of various haematological and biochemical parameters. Yeast counts were assessed by examining 15 microscopic fields, recording the average number of budding yeasts observed before and after treatment. Therapeutic evaluation, pre and post-treatment was based on cytological evaluation (Mean yeast count) and visual analog scale for pruritus (history) generated on day 0 and day 29. Affected skin was sampled with a sterile cotton swab, smeared on a slide, air-dried, heatfixed, and stained with Loeffler's alkaline methylene blue for 2-4 minutes (Selvi et al., 2015) [11] . Diagnosis was based on the presence of more than one budding yeast per oil immersion field with clinical signs. Dog received oral Itraconazole (5 mg/kg, once daily, 2 consecutive days/week for 4 weeks) (Pinchbeck et al., 2002) [8] , antifungal shampoo, a 7-day course of antibiotics, and SKORA-33 supplements (half to one tablet, 10-20 days) according to severity. Haematology and serum biochemistry parameters were taken pre and post treatment for evaluation.

Results and Discussion

Dog presented with dermatological problem suggestive of Malassezia dermatitis was screened and found positive for Malassezia by direct microscopy. Predominant clinical signs observed in the affected dog was pruritus, erythema, scales, hyperpigmentation and otitis. These findings were in accordance with Selvi et al., 2024 [10] , who reported that pruritus, erythema, hyperpigmentation, malodour, and traumatic alopecia are the major clinical signs in dogs with Malassezia dermatitis (fig 1 -5). Haematological and serum biochemical values revealed no difference between pretreatment (0 day) and post-treatment (29 day). Staining the impression smear with methylene blue resulted in a monochromatic view of Malassezia organisms, which appeared under the microscope as small, oval to peanut-or footprint-shaped structures (Fig. 2). Clinical response to supplement therapy was monitored on day 29 after 4 weeks of treatment in terms of cytological evaluation of mean yeast count. The response to therapy on day 29, as compared to day 0 (prior to treatment), was highly significant and there was a considerable reduction in the mean yeast count after treatment. Thus, an excellent clinical response was noticed in a dog supplemented with SKORA 33 along with standard antifungal treatment, with no side effects recorded.

Conclusion

The study showed that adding the nutritional supplement SKORA-33 to standard antifungal therapy significantly improved treatment outcomes. Clinical signs such as pruritus, erythema, scaling, hyperpigmentation, and otitis were markedly reduced over 29 days (Fig. 1) and hair regrowth was observed. Overall skin health improved, with a significant reduction in mean yeast counts on cytology (Patterson and Frank, 2002) [7] . No changes were noted in hematological or biochemical parameters (Table .1), indicating the supplement was well-tolerated. These results support SKORA-33 as a safe and effective adjunct in managing Malassezia dermatitis in dogs, promoting faster and more complete recovery.

Acknowledgement

AcknowledgementsThe authors wish to acknowledge the head of Bark India of charitable Trust, Villupuram for their support and for providing the necessary facilities to carry out this work.

References

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