This is a strategy in four stages:
The first is that of questioning. This allows one to apprehend the individual unique context, in which the illness is expressed. It is the foundation of what is called the global approach, in which the doctor’s attention, following the diagnostic phase centred on the illness, focuses on the patient, on his relations with himself, with his illness and with his treatment. Little by little, one consultation at a time, this dialogue allows the illness to be objectivized, to make it into something one can act upon, not something merely to be endured. The illness becomes an event that doctor and patient alike are able to ponder and work on.
The second stage is that of explanations. We explain to the patient the mechanisms of his illness, what is known about its development and treatment. Together with the patient, we examine any links there may be between what is known of the physiopathology of the illness and his way of life, as well as the ways in which the various treatments available can or cannot be adopted to his day-to-day life. This second stage will allow the patient to understand how he himself can act on the illness, that drugs are there to help him, but cannot substitute him in finding a good quality of life, and that, in some way, he has the wherewithal to master his illness with the help of his doctor.
These two initial stages (the so-called global approach) are enlightened, though not limited by the scientific medicine. The aim of this global, individualized approach is to introduce the third and most important stage, that of therapeutic negotiation. Good negotiations are conducted between two people, each having a different point of view in the true sense, both being informed and in a position of equality, seeking together to find the best possible compromise to resolve a problem. The quality of therapeutic negotiation between doctor and patient will therefore depend on the quality of the first two stages. Through these, the doctor will come to an understanding of the patient’s life pattern and can try to argue from within this set-up. This will enabled the patient to better understand his illness and better understand the various potentials and constraints of the therapeutic tools at his disposal. He gains the ability to personalize this information by relating it to his own situation, to his own way of life, to his own perception of values. From one consultation to the next, he understands that he is acquiring the freedom to take control of his illness.
Hence, between a variety of technically sound possible therapeutic strategies, the negotiation will end in a choice made by or with the patient. This takes us onto the final stage, that of the prescription. In this context, it is by no means a medical prescription, but a contract that concludes the negotiations and, ideally, should be signed by doctor and patient alike.
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Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Screening for cardiovascular comorbidity in United States outpatients with psoriasis, hidradenitis, and atopic dermatitis.
Arch Dermatol Res.
2021 Apr , 313, (3):163-171.
Psoriasis, hidradenitis, and atopic dermatitis (AD) are associated with increased cardiometabolic comorbidities. Yet, little is known about screening rates for cardiometabolic comorbidities in patients with these disorders. The objective of this study is to determine rates and predictors of cardiovascular screening among patients with psoriasis, AD, and hidradenitis in the United States. Data from the 2006-2015 National Ambulatory Medical Care Survey were analyzed, including 67,581 (...)
see on pubmed
Nanoliposomes@Transcutol for Skin Delivery of 8-Methoxypsoralen.
Sinico C et al.
Nanoliposomes@Transcutol for Skin Delivery of 8-Methoxypsoralen.
J Nanosci Nanotechnol.
2021 May 01, 21, (5):2901-2906.
8-methoxypsoralen is the most common drug in psoralen plus ultraviolet light irradiation therapy for the treatment of severe psoriasis. Despite of the efficacy, its classic oral administration leads to several serious adverse effects. However, the topical psoralen application produces a drug skin accumulation lower than that obtained by oral administration, due to the drug low skin permeability. In this paper, 8-methoxypsoralen loaded Penetration Enhancer-containing Vesicles were prepared (...)
see on pubmed
Catalpol ameliorates psoriasis-like phenotypes via SIRT1 mediated suppression of NF-κB and MAPKs signaling pathways.
Bioengineered.
2021 Dec , 12, (1):183-195.
Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of worldwide population, and causing long-term troubles to the patients. Therefore, it is urgent to develop safe and effective therapeutic drugs. Catalpol is a natural iridoid glucoside, that has several remarkable pharmacological effects, however, whether catalpol can alleviated psoriasis has not been explored. The goal of the present work is to study the role of catalpol in psoriasis in vivo and in vitro. (...)
see on pubmed
on Atopic Dermatitis
Screening for cardiovascular comorbidity in United States outpatients with psoriasis, hidradenitis, and atopic dermatitis.
Arch Dermatol Res.
2021 Apr , 313, (3):163-171.
Psoriasis, hidradenitis, and atopic dermatitis (AD) are associated with increased cardiometabolic comorbidities. Yet, little is known about screening rates for cardiometabolic comorbidities in patients with these disorders. The objective of this study is to determine rates and predictors of cardiovascular screening among patients with psoriasis, AD, and hidradenitis in the United States. Data from the 2006-2015 National Ambulatory Medical Care Survey were analyzed, including 67,581 (...)
see on pubmed
Qingxue jiedu formulation ameliorated DNFB-induced atopic dermatitis by inhibiting STAT3/MAPK/NF-κB signaling pathways.
J Ethnopharmacol.
2021 Apr 24, 270:113773.
Qingxue jiedu Formulation (QF) is composed of two classic prescriptions which have been clinically used for more than 5 centuries and appropriately modified through basic theory of traditional Chinese medicine for treating various skin inflammation such as atopic dermatitis (AD), acute dermatitis and rash. Although QF possesses a prominent clinical therapeutic effect, seldom pharmacological studies on its anti-AD activity are (...)
see on pubmed
Methicillin-resistant from infected skin lesions present several virulence genes and are associated with the CC30 in Brazilian children with atopic dermatitis.
Virulence.
2021 Dec , 12, (1):260-269.
Atopic dermatitis (AD) is a chronic inflammatory skin disease and colonization by may affect up to 100% of these patients. Virulent and resistant isolates can worsen AD patient clinical condition and jeopardize the treatment. We aimed to detect virulence genes and to evaluate the biofilm production of isolates from infected skin lesions of children with AD. Methicillin resistance was detected by phenotypic and molecular tests and the virulence genes were detected by PCR. Biofilm formation (...)
see on pubmed