RESUMO
BACKGROUND: Conjunctivitis is common in patients with atopic dermatitis (AD) in general and a commonly reported adverse event in AD clinical trials with dupilumab. OBJECTIVE: To survey opinions and experience about conjunctivitis occurring in AD, including those during dupilumab treatment in a group of AD experts from the International Eczema Council (IEC). METHODS: Electronic survey and in-person discussion of management strategies. RESULTS: Forty-six (53.5%) IEC members from 19 countries responded to the survey. Consensus was reached for several statements regarding diagnostic workup, referral and treatment. IEC members suggest that patients with AD should (i) routinely be asked about ocular complaints or symptoms, (ii) obtain information about the potential for conjunctivitis before starting dupilumab therapy and (iii) if indicated, be treated with dupilumab despite previous or current conjunctivitis. In cases of new-onset conjunctivitis, there was consensus that dupilumab treatment should be continued when possible, with appropriate referral to an ophthalmologist. LIMITATIONS: The study relies on expert opinion from dermatologists. Responses from few dermatologists without dupilumab access were not excluded from the survey. CONCLUSION: The IEC recommends that dermatologists address conjunctivitis in patients with AD, especially during treatment with dupilumab.
Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Conjuntivite/tratamento farmacológico , Dermatite Atópica/complicações , Fármacos Dermatológicos/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Conjuntivite/etiologia , Consenso , Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Humanos , Pomadas/uso terapêutico , Soluções Oftálmicas/uso terapêutico , Educação de Pacientes como Assunto , Encaminhamento e Consulta , Inquéritos e QuestionáriosRESUMO
The clinical manifestations of zinc deficiency and anorexia nervosa are remarkably similar, and a number of studies have demonstrated that there may be a positive correlation between zinc therapy and the rate of recovery of anorexia nervosa patients. However, because of the different interpretations of the results of these studies, the use of zinc supplementation varies. This article examines the evidence supporting zinc supplementation in the treatment of anorexia nervosa. Randomised, double-blind, controlled clinical trials indicate that zinc therapy enhances the rate of recovery in anorexia nervosa patients by increasing weight gain and improving their levels of anxiety and depression. On the basis of these findings and the low toxicity of zinc, zinc supplementation should be included in the treatment protocol for anorexia nervosa.