Dhossche Julie, Corn Josh, Simpson Eric L, Funk Tracy
Department of Dermatology, Oregon Health & Science University, Portland, OR, USA.
National University of Natural Medicine, Portland, OR, USA.
Pediatr Dermatol. 2020 Jan;37(1):109-114. doi: 10.1111/pde.14036. Epub 2019 Nov 19.
Atopic dermatitis (AD) patients frequently use both conventional and complementary medicines for treatment. Allopathic and naturopathic providers may be unaware of each other's approach to AD diagnosis, skin care, and treatment, affecting patient and provider communication, patient safety, and potential for collaborative studies.
To identify core commonalities and differences in allopathic and naturopathic approach to AD.
Thirty allopathic and 21 naturopathic providers completed an 11-question free-text comment survey, covering patient education and evaluation, skin care, and treatment of AD. Qualitative content analysis detected key ideas and concepts, and word cloud analysis provided a quantitative visual representation of recurrent words in each group's responses.
All respondents indicated using similar physical features to diagnose AD. In both allopathic and naturopathic fields, the majority of providers did not perform routine testing for AD diagnosis. Skin care with moisturization and "soak-and-seal" bathing practices were routine in both fields. Naturopathic providers heavily emphasized the role of food and diet in AD pathogenesis, education, and management, while allopathic providers indicated little to no role for food and diet in AD. For treatment, allopathic providers favored topical steroids, phototherapy, and immunomodulators, whereas naturopathic providers recommended botanicals, supplements, and other complementary and alternative methods.
Providers should be aware of the differences between allopathic and naturopathic providers and their approach to AD management, particularly concerning the role of food and diet. There may be opportunities to harmonize skin care regimens for patients given similar approach in both fields, and to collaborate further on studies of diet in AD and treatments not yet effectively tested.
特应性皮炎（AD）患者经常使用传统药物和补充药物进行治疗。对抗疗法和自然疗法的医疗服务提供者可能并不了解彼此对AD诊断、皮肤护理和治疗的方法，这会影响医患沟通、患者安全以及合作研究的可能性。
确定对抗疗法和自然疗法在AD治疗方法上的核心共性和差异。
30名对抗疗法医疗服务提供者和21名自然疗法医疗服务提供者完成了一项包含11个问题的自由文本评论调查，内容涵盖患者教育与评估、皮肤护理以及AD的治疗。定性内容分析检测关键思想和概念，词云分析则以定量可视化方式呈现每组回答中反复出现的词汇。
所有受访者均表示使用相似的身体特征来诊断AD。在对抗疗法和自然疗法领域，大多数医疗服务提供者在AD诊断时都不进行常规检测。保湿皮肤护理和“浸泡 - 封包”沐浴方法在两个领域都是常规操作。自然疗法医疗服务提供者高度强调食物和饮食在AD发病机制、教育和管理中的作用，而对抗疗法医疗服务提供者则表示食物和饮食在AD中作用很小或几乎没有作用。在治疗方面，对抗疗法医疗服务提供者倾向于使用外用类固醇、光疗和免疫调节剂，而自然疗法医疗服务提供者推荐植物药、补充剂以及其他补充和替代方法。
医疗服务提供者应了解对抗疗法和自然疗法医疗服务提供者之间的差异以及他们对AD管理的方法，特别是在食物和饮食的作用方面。鉴于两个领域在皮肤护理方案上有相似方法，可能有机会为患者统一皮肤护理方案，并在AD饮食研究和尚未有效测试的治疗方法上进一步合作。
