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
Evaluation of the possible use of genus Mentha derived essential oils in the prevention of SENLAT syndrome caused by Rickettsia slovaca.
J Ethnopharmacol.
2019 Mar 25, 232:55-61.
Essential oils and essential oil bearing medicinal and culinary plants have a long tradition of being used to combat infection, treat various conditions, and promote and restore health. Mint oils are traditionally applied to repel insects and treat various conditions including wounds, skin infections, inflammation, eczema, urticaria, psoriasis, scabies and insect bites. They are among essential oils promoted as a natural way to prevent tick-borne diseases and recommended as ingredients in (...)
see on pubmed
Downregulated miR-187 contributes to the keratinocytes hyperproliferation in psoriasis.
Tang L et al.
Downregulated miR-187 contributes to the keratinocytes hyperproliferation in psoriasis.
J. Cell. Physiol..
2019 Apr , 234, (4):3661-3674.
Psoriasis is a common chronic skin disease characterized by epidermal hyperplasia and inflammation. However, the pathogenesis of psoriasis is multifactorial and is not fully understood. MicroRNAs (miRNAs) represent a promising class of small, noncoding RNA molecules that have a large impact on cellular functions by regulating gene expression. Here we reported that microRNA-187 (miR-187), which is one of the most dynamic microRNAs identified in the deep screening miRNAs profile, is (...)
see on pubmed
Risk of myocardial infarction in patients with psoriasis: A cross-sectional patient-population study in a Japanese hospital.
J Cardiol.
2019 Apr , 73, (4):276-279.
Some epidemiological studies have demonstrated the association between psoriasis vulgaris and coronary artery disease (CAD). However, there is a lack of specific data regarding the association between psoriasis vulgaris and myocardial infarction (MI), the more severe and critical presentation of CAD, in the Japanese population.
see on pubmed
on Atopic Dermatitis
Icariin inhibits inflammation via immunomodulation of the cutaneous hypothalamus-pituitary-adrenal axis in vitro.
Clin. Exp. Dermatol..
2019 Mar , 44, (2):144-152.
Dysfunction of skin steroidogenesis plays an important role in inflammatory skin diseases. We previously carried out an animal study which showed that icariin could inhibit the inflammation of atopic dermatitis by regulating the cutaneous hypothalamus-pituitary-adrenal axis (HPAA).
see on pubmed
Neopterin Levels and Indoleamine 2,3-Dioxygenase Activity as Biomarkers of Immune System Activation and Childhood Allergic Diseases.
Ann Lab Med.
2019 May , 39, (3):284-290.
Although Th2 immune activation is predominant in allergic diseases, neopterinlevels and indoleamine 2,3-dioxygenase (IDO)-1 activity (kynurenine:tryptophan ratio), which reflect Th1 immune activity, increase with interferon-gamma (IFN-γ) stimulation. We investigated neopterin, tryptophan, and kynurenine levels as biomarkersof the Th1 immune system activation and changes in IDO-1 activityin children with asthma, allergic rhinitis, and atopic dermatitis, as well as the relationship between (...)
see on pubmed
Effect of cinnamamides on atopic dermatitis through regulation of IL-4 in CD4 cells.
Choi EJ et al.
Effect of cinnamamides on atopic dermatitis through regulation of IL-4 in CD4 cells.
J Enzyme Inhib Med Chem.
2019 Dec , 34, (1):613-619.
This study aimed to evaluate the effects of cinnamamides on atopic dermatitis (AD) and the mechanisms underlying these effects. To this end, the actions of two cinnamamides, (E)-3-(4-hydroxyphenyl)-N-phenylethyl acrylamide (NCT) and N-trans-coumaroyltyramine (NCPA), were determined on AD by orally administering them to mice. Oral administration of the cinnamamides ameliorated the increase in epidermal and dermal thickness as well as mast cell infiltration. Cinnamamides suppressed serum (...)
see on pubmed