ObjectiveTo assess the efficacy and safety of compound flumetasone ointment for neurodermatitis and chronic eczema. MethodsWe searched the Medline, Cochrane Central Register of Controlled Trials, EMbase, CBM, CNKI and Wanfang Data to collect randomized controlled trials (RCTs) of compound flumetasone ointment for neurodermatitis and chronic eczema; the retrieval time started from founded date to December 2012. The language was confined to English and Chinese. We performed meta-analyses using the Cochrane Collaboration's RevMan 5.0 Software. ResultsA total of 22 RCTs involving 2 049 patients with neurodermatitis and chronic eczema were included and assessed. At the end of the 2nd, 3rd and 4th week, the efficacy of topical compound flumetasone ointment (or combined with oral antihistamines) was obviously higher than that of other topical corticosteroid preparations[RR=1.39, 95%CI(1.30, 1.50), P<0.000 01; RR=1.25, 95%CI(1.15, 1.37), P<0.000 01; RR=1.21, 95%CI(1.11, 1.33), P<0.000 1]. Only temporary and slight adverse effects, such as erythema, desquamation, burning and tingling were observed, whereas no serious adverse effects were reported. ConclusionThe limited evidence demonstrates that topical compound flumetasone ointment (or combined with oral antihistamines) is safe and efficient. More large sampled and multiple central RCTs are required to verify these conclusions owing to the limitations of the present study.
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by severe itching and recurrent eczema-like lesions. With the increase in the global incidence of AD, the incidence of ocular complications in patients also increases. Retinal detachment (RD) seriously affects the vision of patients, and is more common in young and middle-aged people, often involving both eyes with poor prognosis. What’s more, there are many similarities between RD associated with AD and traumatic RD, such as peripheral retinal breaks, giant retinal tears and retinal dialysis. Regarding the mechanism of AD complicated with RD, the trauma theory is widely accepted. Scholars have also reported on the theory of anterior eye developmental abnormalities, inflammation-traction theory, and ectodermal origin theory. On AD complicated with RD, regardless of scleral buckling surgery or vitrectomy surgery, the rate of first retinal reattachment is low with severe proliferative vitreoretinopathy or chronic uveolar inflammation after surgery, which cause traction on the ciliary body and the retina separation appearance again or new cracks appearance. Combination of behavioral therapy, drug therapy and psychotherapy can effectively reduce the occurrence of RD; prevention of eye rubbing, reduction of traumatic exercise, rational use of glucocorticoids or immunosuppressants under the guidance of dermatologists are effective ways for AD patients to prevent RD occurrence. Regular eye examinations can help patients find RD as soon as possible so that they can be treated in time.