ABSTRACT
Many dermatologic diseases are chronic with no definitive cure. For some diseases, the etiology is not completely understood, with treatment being difficult and associated with side effects. In such cases, patients may try alternative treatments to prevent onset, reduce symptom severity, or prevent reoccurrence of a disease. Dietary modification, through supplementation and exclusion, is an extremely popular treatment modality for patients with dermatologic conditions. It is, therefore, important for dermatologists to be aware of the growing body of literature pertaining to nutrition and skin disease to appropriately inform patients on benefits and harms of specific dietary interventions. We address the role of nutrition in psoriasis, atopic dermatitis, urticaria, and bullous diseases and specific dietary modifications as an adjunct or alternative to conventional therapy.
Subject(s)
Diet , Dietary Supplements , Skin Diseases/diet therapy , Skin Diseases/drug therapy , Trace Elements/therapeutic use , Vitamins/therapeutic use , Acrodermatitis/drug therapy , Acrodermatitis/etiology , Dermatitis, Atopic/diet therapy , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/etiology , Food Hypersensitivity/complications , Humans , Necrolytic Migratory Erythema/etiology , Pellagra/drug therapy , Porphyrias, Hepatic/diet therapy , Porphyrias, Hepatic/drug therapy , Porphyrias, Hepatic/etiology , Psoriasis/diet therapy , Psoriasis/drug therapy , Psoriasis/etiology , Skin Diseases/etiology , Skin Diseases, Vesiculobullous/diet therapy , Skin Diseases, Vesiculobullous/drug therapy , Skin Diseases, Vesiculobullous/etiology , Urticaria/diet therapy , Urticaria/drug therapy , Urticaria/etiology , Zinc/deficiencySubject(s)
Bariatric Surgery , Gastrectomy , Paralysis/etiology , Porphyrias, Hepatic/diet therapy , Postoperative Complications/diet therapy , Abdominal Pain/etiology , Adult , Contraindications , Female , Humans , Obesity/surgery , Porphobilinogen Synthase/deficiency , Porphyrias, Hepatic/diagnosis , Postoperative Complications/diagnosis , Vomiting/etiology , Weight GainABSTRACT
Porphyria is a diverse group of diseases in which the biosynthesis of heme is disrupted by either genetic defects or environmental factors. This review gives an overview of the different types of porphyria and describes possible causes, clinical signs, diagnosis and therapy. In addition, the oral manifestations of porphyria and the potential implications of the disease for dental management are discussed.
Subject(s)
Mouth Diseases/etiology , Porphyria, Erythropoietic/complications , Porphyrias, Hepatic/complications , Algorithms , Anesthesia, Dental , Arginine/therapeutic use , Blister/drug therapy , Blister/etiology , Carbohydrates/therapeutic use , Contraindications , Heme/biosynthesis , Heme/therapeutic use , Humans , Mouth Diseases/drug therapy , Photophobia/etiology , Porphobilinogen Synthase/deficiency , Porphyria, Erythropoietic/diet therapy , Porphyria, Erythropoietic/drug therapy , Porphyrias, Hepatic/diet therapy , Porphyrias, Hepatic/drug therapy , Tooth Discoloration/etiologyABSTRACT
Las porfirias son un conjunto de enfermedades metabólicas debidas a alteraciones, genéticas o adquiridas, de la actividad de enzimas de la vía de síntesis de las porfirinas. Los pacientes con porfirias de tipo agudo en remisión, deben someterse a una dieta personalizada hipograsa con un alto contenido de carbohidratos y un adecuado aporte de fibra dietaria y nutrientes esenciales. Los pacientes con porfirias agudas deben evitar la ingesta de alcohol, los ayunos prolongados y los ejercicios extenuantes. El tratamiento de elección de las crisis porfíricas es la administración por vía enteral y/o parenteral de una sobrecarga de carbohidratos. Los pacientes con porfirias con alteración cutáneas, deben seguir un régimen dietario similar al de aquellos con profirias agudas en fase de remisión. En la protoporfiria eritrocitaria se debe asegurar un adecuado aporte de hierro, en cambio en la porfiria cutánea tarda debe restringirse su ingesta, especialmente si es hemínico, así como también el consumo de alcohol
Subject(s)
Humans , Male , Female , Porphyrias, Hepatic/diet therapy , Diet, Fat-Restricted , Dietary Carbohydrates/administration & dosage , Dietary Fiber/administration & dosage , Porphyrins/metabolismABSTRACT
Certain of the hepatic porphyrias are classified as belonging to the acute hepatic prophyrias, namely acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP) and ALA-dehydrase deficiency. The common feature of all acute hepatic porphyrias is the sudden onset of neurological symptoms. The whole syndrome consists of acute abdominal pain crises with autonomic dysfunction, global or focal central nervous system involvement and a predominantly motor polyneuropathy. Mono- or oligosymptomatic manifestations of acute porphyrias occur and are probably underestimated. The laboratory diagnosis of porphyria depends on the measurement of porphyrin precursors in urine, whereas the measurement of porphyrins in urine and feces is essential for evaluation of the porphyria type. Enzyme measurements are used to identify asymptomatic family members whose quantitative excretions of porphyrins are normal. At present the pathogenesis of neurological manifestations of acute porphyrias remains an unsettled question. The major hypotheses are discussed in this paper. The most important precipitating factor in acute hepatic porphyrias is drug ingestion. As many new drugs have not been in use for sufficiently long periods to assess their porphyrogenic activity, it is safer to avoid drugs in patients with porphyria. The most effective treatment of porphyria attacks is the administration of heme. Among the porphyria patients with epileptic seizures requiring antiepileptic medication, treatment with bromides should be taken into consideration.
