Approaching the future management of sweet itch

Abstract

Insect bite hypersensitivity, commonly known as the ‘sweet itch’, continues to prove frustrating to manage in practice. Insect bite hypersensitivity is the most common allergic skin disease in horses, characterised as a hypersensitivity to the salivary proteins of the Culicodes genus of insects. The complex nature of this allergic disease means that no set of affected horses can be managed in the same way. Common approaches to sweet itch can be broken down into the categories of anti-inflammatories, allergen avoidance, skin conditioning and immunotherapy. Many effective management techniques focus on avoiding insect bites and regularly washing skin. Advances are currently being made towards effective immunotherapy, with varied results in clinical trials and in practice. As a result of this, a multimodal approach to the management of insect bite hypersensitivity is often recommended.