Malassezia pachydermatis (M. pachydermatis) otitis is an important infectious disease of dogs throughout the world. In the present study, the presence, diagnosis, clinical signs and chemotherapy of M. pachydermatis were studied in clinical otitic dogs of Lahore and its suburbs. During two-year study period, a total of 200 ear cerumen samples from otitic dogs were examined microscopically. Of these, 46 (23%) were found positive for M. pachydermatis. The difference in the prevalence of infection between the pendulous ear and erected ear dogs as well as sex predilection was found nonsignificant (P>0.05). However, a significantly (P<0.05) higher prevalence (86.90%) was recorded in dogs of more than one years of age group. The animals determined positive for the M. pachydermatis were divided into two groups (A and B) and treated with Clotrimazole and Nystatin, respectively. Efficacy of both the antifungals was evaluated on the basis of reversal of clinical signs scoring and cytological examinations at 7, 14, 21-day post treatment. The overall efficacy of Clotrimazole and Nystatin was 73% and 68%, respectively. Clotrimazole showed better results as compared to Nystatin in accomplishing cure rate from mycological infection. It was concluded that M. pachydermatis is a significant cause of otitis in dogs wherein Clotrimazole proves to be a more effective drug in eliminating the infection in the affected Dogs.

Demacort® is mixture of betamethasone (high-potency corticosteroid) and clotrimazole (antifungal agent), an inhibitor of CYP3A4, which can inhibit the metabolism of betamethasone. Interaction of these drugs may result in decreased clearance of betamethasone and increased risk for adverse events such as iatrogenic Cushing’s syndrome. A 26-year-old female was admitted to the hospital due to rapid weight gain after application of Demacort®. During a period of one month, she showed weight gain of 30 kg and developed several Cushingoid appearances. The result of an overnight dexamethasone suppression test was negative, thus, endogenous Cushing’s syndrome was ruled out. A negative cortisol response was observed for the rapid ACTH stimulation test; therefore, we made a diagnosis of iatrogenic Cushing’s syndrome combined with additional secondary adrenal insufficiency.