dupilumab may lead to fewer GCs and decreased mucin production, which could affect the tear film and result in conjunctival inflammation. 2 Importantly, these results do not correspond with the findings of atopic keratoconjunctivitis or allergic conjunctivitis, which often show an increased GC density and increased mucus production, nor do they fit with a diagnosis of ocular rosacea. 2 A recent article by Yamane et al 3 addresses speculation about periocular dermatitis and suggests that this may indeed be associated with the conjunctivitis, at least in some patients, and appears to improve along with the conjunctivitis as the drug reaches undetectable levels.There is clearly much left to learn, but it is our sincere hope that with both intradisciplinary and interdisciplinary collaboration, great strides in understanding both the disease state as well as this important adverse effect will be made in short time.
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