P96 Nutrition in dermatology practice: an unmet need for both patients and healthcare professionals

Abstract

Abstract The role of diet and nutrition in the management of chronic inflammatory skin conditions such as eczema, psoriasis and acne is one of the commonest questions asked by patients. Despite this, there is little guidance or training to help healthcare professionals provide disease-specific evidence-based recommendations to patients. Furthermore, growing evidence supports the role of diet and nutrition in the management of skin conditions such as psoriasis and atopic eczema. We sought to explore dermatology professionals’ experiences of patients’ dietary habits in an outpatient setting. We circulated a questionnaire to members of the British Dermatological Nursing Group and the British Association of Dermatologists. We collected demographic data, along with information on how frequently professionals were asked about diet by patients, how confident they felt responding to questions and concerns expressed regarding dietary restrictions, and whether dietitian input or nutrition training would be of benefit to their practice. Three of the authors received funding from the Psoriasis Association. We received 95 responses from dermatology nurses and 64 from doctors. Over 60% of respondents held senior positions with over 10 years of experience. Almost 100% of respondents reported being asked about diet by patients and 73.1% did not feel confident when answering these questions. Patients were most commonly asked about nutrition in relation to inflammatory conditions such as eczema (95.3%), acne (95.3%) and psoriasis (76.6%). All doctors and 97.8% of nurses reported having experienced patients restricting their diet without supervision, and the majority expressed concerns about such dietary modifications. Dairy, gluten and refined sugar were the most commonly excluded foods. Professionals also reported that patients admitted to following restrictive diets and undertaking ‘food intolerance testing’ that they had encountered online. Over 90% of respondents felt that additional nutrition training and access to specialist dietician support would be of benefit to dermatology practice. Dermatology professionals are frequently asked about nutrition and the role of diet yet often lack confidence in responding to these enquiries. Dermatology patients appear vulnerable to dietary misinformation presented online regarding ‘intolerance tests’, and this has the potential to worsen with ongoing delayed access to secondary care. There are also concerns regarding unsupervised restrictive diets, which can negatively impact patients’ mental health and predispose to eating disorders and nutritional deficiencies. Specialist nutrition training for dermatology professionals and the support of dietitians in the clinical setting would help address this unmet need and provide holistic patient care.