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Acne Severity (acne + severity)
Selected AbstractsChanges of psychiatric parameters and their relationships by oral isotretinoin in acne patientsTHE JOURNAL OF DERMATOLOGY, Issue 5 2009Bong Jin HAHM ABSTRACT Oral isotretinoin is a highly effective agent for the treatment of moderate to severe acne, but ever since oral isotretinoin was introduced as a modality for acne, the relationship between oral isotretinoin therapy and psychiatric problems, especially depression, has been controversial. The purposes of this study were to know the acute effects of oral isotretinoin therapy on psychiatric symptoms and to investigate the relationships among them, which have not been reported in the published work. This cohort study included 38 acne patients who started oral isotretinoin therapy. Individual patients were examined before administering oral isotretinoin and 2 and 8 weeks after commencement. Acne severity was graded using the Leeds revised acne grading system. Acute psychiatric effects of oral isotretinoin were assessed using a questionnaire authorized by two psychiatrists. This questionnaire included assessments of acne-related quality of life (Assessment of the Psychological and Social Effects of Acne [APSEA]), depression (Beck's depression inventory [BDI]), anxiety (Beck's anxiety inventory [BAI]) and psychopathology (Symptomchecklist-90-revised [SCL-90-R]). Acne grading and APSEA showed similar change patterns. Both improved after 8 weeks of oral isotretinoin treatment. On the other hand, the severity of depression decreased after 2 weeks of treatment. A significant correlation was found between BDI and APSEA, but no correlation was found between BDI and acne grade. These results indicate that oral isotretinoin therapy alleviates depressive symptoms. Improvements in depression are directly related to acne-related life quality improvements rather than to improvement in acne grade. [source] Acne vulgaris in Nigerian adolescents , prevalence, severity, beliefs, perceptions, and practicesINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2009Husain Yahya MSc Background, Community-based studies of acne vulgaris conducted in many parts of the world show that it is very common in adolescents but little is known from Africa. Methods, In a cross-sectional study, 539 randomly selected students aged 11,19 years in a secondary school in Kaduna, Nigeria were administered a questionnaire to assess self-report of acne, its severity and impact; beliefs and perceptions of causes, and treatments used. 418 students were later examined to detect and grade acne severity. Results, 274 (50.8%) were male while 265 (49.2%) were female. Mean age for respondents was 16 years. 320 students (59.4%) self-reported acne. Of 418 students examined, 379 had acne giving a prevalence of 90.7%. There was no significant gender difference in prevalence at all ages of adolescence. Prevalence of acne increased with age (76.7% at age 10,13 years; 88.2% at age 14,16 years; 97.1% at age 17,19 years). 353 of 379 (93.1%) had mild acne while 26 of 379 (6.9%) had moderate acne. The severity of acne was similar in boys and girls. 47.7% of students reported feeling "very sad/unhappy" about their acne although in more than 70% of those who self-reported, this did not interfere with relationship with family, friends or school work. Diet was the commonest factor believed to cause acne. Cleansing agents were the most commonly used treatments. Conclusions, Acne vulgaris is very common in Nigerian adolescents, although it is mild acne in most. [source] Acne's relationship with psychiatric and psychological morbidity: results of a school-based cohort study of adolescentsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2010PJ Magin Abstract Background, There is a considerable number of studies linking acne with psychological and psychiatric morbidities, although this literature is not entirely consistent and is largely cross-sectional in methodology. Objective, This study aims to establish the relationship of acne and psychological and psychiatric morbidity in adolescents in a community setting and, via a longitudinal methodology, provide evidence for causality in the relationship. Methods, The study was a 12-month cohort study. Two hundred and forty-four students in Years 8, 9 and 11 (ages 14,17) at four Australian high schools were assessed at baseline 6 months and 12 months. Presence and severity of acne were assessed, along with a number of psychological and psychiatric morbidities and personality traits (depression, anxiety, overall psychiatric morbidity, self-consciousness, neuroticism and introversion/extraversion) and other demographic variables. Results, Of the 244 participating students, 209 (86%) completed all three rounds of data collection. A further 26 (11%) completed two rounds. The study failed to demonstrate an association of the presence of acne or of acne severity with the examined measures of psychological and psychiatric morbidity, and no evidence for an effect of acne in their causation. Conclusion, The relationship of acne and psychological morbidities found in previous health care settings was not found in this community sample. This may be due to differences between community and clinical acne populations. Other possible reasons for this finding are attenuation of psychological morbidity in subjects in this study by successful acne treatment, and the role of personality traits in the complex relationship between acne and psychological morbidities. It is suggested that this relationship would be best investigated by means of longer-term cohort studies enlisting subjects at an zearly age, prior to the onset of acne. [source] Quality of life in mild to moderate acne: relationship to clinical severity and factors influencing change with treatmentJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2007M Jones-Caballero Abstract Background, Because of its effects on quality of life, acne vulgaris is more than a merely physiological or cosmetic entity. Objectives, To describe the influence of mild to moderate acne on patients' quality of life, measured using Skindex-29, and to correlate changes in Skindex-29 scores with changes in objective and subjective indices in clinical severity after treatment with topical 4% erythromycin 0.2% zinc. Also, to evaluate efficacy and side-effects of the treatment. Methods, Observational, prospective study of 1878 patients cared for by 252 clinicians in Spain. Data included epidemiological information and responses to Skindex-29, a subjective change and objective severity index. Results, Baseline Skindex scale scores were worse in women, older patients, and those with more severe clinical disease. Skindex was sensitive to changes in objective severity but changes in Skindex scale scores were also related to other factors. Patients who reported their skin condition to be ,the same' or ,worse' at the end of the study had significantly worse baseline scores on the ,symptoms' and ,emotions' scales but ,functioning' scores were not worse than for those who reported their condition had improved. Conclusion, The effects of acne vulgaris on quality of life and changes in quality of life after treatment are not only explainable by objective severity of acne. Patients' and clinicians' judgements about acne severity are different. [source] A Novel Gel Formulation of 0.25% Tretinoin and 1.2% Clindamycin Phosphate: Efficacy in Acne Vulgaris Patients Aged 12 to 18 YearsPEDIATRIC DERMATOLOGY, Issue 3 2009Lawrence F. Eichenfield M.D. Recently, the US FDA approved the combination of 1.2% clindamycin (CLIN) and 0.025% tretinoin (RA) in a novel gel formulation for the treatment of mild to moderate acne, based on results from two 12-week, multicenter, double-blind Phase 3 trials in which patients were randomized to four treatment arms: CLIN/RA, CLIN, RA, and vehicle. The trials studied more than 4500 patients 12 years of age or older. In both trials, CLIN/RA gel produced significantly greater clinical improvements than vehicle or either monotherapy. CLIN/RA was safe and well tolerated in both trials and in a 52-week safety follow-up evaluation. The current study is a subgroup analysis that evaluates CLIN/RA's effects on acne lesion prevalence in 12- to 18-year-old patients with mild to severe baseline acne severity. CLIN/RA significantly reduced the number of inflammatory, noninflammatory, and total acne lesions after 12 weeks of treatment (p , 0.004) in 1,710 patients aged 12 to 18 years. Relatively greater improvements were seen following CLIN/RA treatment compared to CLIN or RA monotherapy, or the vehicle gel beginning as early as 2 weeks following treatment initiation. This novel CLIN/RA gel for treating acne is tolerable and safe and offers clinicians and teen aged patients a new and efficacious intervention for acne vulgaris. [Abstract amended after online publication date June 8, 2009] [source] Establishment of grading criteria for acne severityTHE JOURNAL OF DERMATOLOGY, Issue 5 2008Nobukazu HAYASHI ABSTRACT For the epidemiological surveys and evaluations of therapy, it is essential to evaluate the severity of diseases. There are several reported methods of assessment for acne severity including lesion counting, comparison of the patient's to a photographic standard and comparison of the patient's to a text description. But all of these are based on opinions of specialists. In this study, we attempted to make an evidence-based grading criteria for acne severity, which was expected to yield consents from most dermatologists. The dermatologists consulted classified the global severity of acne patients without any standard and then counted the numbers of eruptions. Three independent expert dermatologists graded the photographs of these patients. We compared the verdicts of the consulted dermatologist and three experienced dermatologists, and analyzed the relationships between these classifications and numbers of eruptions. Our results showed that most of the dermatologists have similar latent recognitions of acne severity. We selected representative photographs as standards, which would contribute to making adjustments for judgments. Global classifications of dermatologists correlated with numbers of inflammatory eruptions (papules plus pustules), but did not with numbers of comedones. The appropriate divisions of inflammatory eruptions of half of the face to decide classifications were: 0,5, "mild"; 6,20, "moderate"; 21,50, "severe"; and more than 50, "very severe". [source] Evaluation of the newly established acne severity classification among Japanese and Korean dermatologistsTHE JOURNAL OF DERMATOLOGY, Issue 5 2008Nobukazu HAYASHI ABSTRACT Recently, we established an acne severity classification that is based on scientific evidence. Our classification allows three different methods for grading, which include general impression of consulted dermatologist, photograph-based estimation by independent experts, and grading by lesion counting. In our classification, we proposed standard photographs for the estimation of general severity to adjust the basis of judgments. In this study, we evaluated the validity of our classification. We made questionnaires of acne severity using acne patients' photographs, which were selected from the collection of representative photographs of our classification. Participants answered these questionnaires before and after our presentations about our classification of acne severity. We identified the conformity rate with our consensus decision. The results revealed that average conformity rates were raised from 67.0% to 88.9% among Japanese dermatologists and from 68.0% to 79.8% among Korean ones. These data show the adequacy of both our grading system itself and its presentation. We believe our classification will be one of the most effective and reasonable grading systems to classify acne severity. [source] Effects of skin care and makeup under instructions from dermatologists on the quality of life of female patients with acne vulgarisTHE JOURNAL OF DERMATOLOGY, Issue 11 2006Yoshie MATSUOKA ABSTRACT Acne vulgaris significantly affects patients' quality of life (QOL) and their lives in various ways, including social behavior and body dissatisfaction. This may be heightened by acne's typical involvement of the face. We investigated whether the use of skin care and makeup could influence the QOL of affected patients without deteriorating conventional acne treatments. Fifty female patients with acne were recruited for our study. Twenty-five patients were instructed how to use skin care and cosmetics, while 25 patients received no specific instructions from dermatologists. Both groups received conventional topical and/or oral medication for acne during the study period for 4 weeks. Both groups did not show any significant difference in clinical improvement of acne severity. Two validated QOL questionnaires, World Health Organization (WHO)QOL26 and the Dermatology Life Quality Index (DLQI) were administered to all patients at first visit and 4 weeks later. The mean scores of psychological and overall domains in WHOQOL26 for patients with instructions were improved significantly, while only the overall score was significantly improved for patients without instructions. The total mean scores and all domains except work/school in DLQI for patients with instructions were improved significantly, while the total scores and all domains except discomfort for treatment in DLQI were significantly improved for patients without instructions. Thus, instructions on the use of skin care and cosmetics for female acne patients did not deteriorate acne treatment and influenced patients' QOL effectively. We therefore suggest that instructions for using skin care and cosmetics complement conventional medical treatments for acne. [source] Topical aminolaevulinic acid-photodynamic therapy for the treatment of acne vulgaris: a study of clinical efficacy and mechanism of actionBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2004B. Pollock Summary Background, ,Acne affects 83,95% of 16-year-olds of both sexes, and many seek help from a clinician. Emerging problems with conventional acne treatments, specifically antibiotic resistance of Propionibacterium acnes and fears over the safety and tolerance of oral isotretinoin, create a demand for novel treatment modalities in acne. Objectives, To study the efficacy of aminolaevulinic acid-photodynamic therapy (ALA-PDT) in the treatment of acne and to identify the mode of action, looking specifically at the effects on surface numbers of P. acnes and on sebum excretion. Methods, ,Ten patients (nine men and one woman, age range 16,40 years) with mild to moderate acne on their backs were recruited. Each patient's back was marked with four 30-cm2 areas of equal acne severity. Each site was then randomly allocated to either ALA-PDT treatment, light alone, ALA alone or an untreated control site. At baseline, numbers of inflammatory and noninflammatory acne lesions were counted, sebum excretion measured by Sebutapes (CuDerm, Dallas, TX, U.S.A.) and surface P. acnes swabs performed. ALA cream (20% in Unguentum Merck) was applied under occlusion to the ALA-PDT and ALA alone sites for 3 h. Red light from a diode laser was then delivered to the ALA-PDT and light alone sites (635 nm, 25 mW cm,2, 15 J cm,2). Each patient was treated weekly for 3 weeks. At each visit acne lesion counts were performed and 3 weeks following the last treatment sebum excretion rates and P. acnes swabs were repeated. Results, There was a statistically significant reduction in inflammatory acne lesion counts from baseline after the second treatment at the ALA-PDT site but not at any of the other sites. No statistically significant reduction in P. acnes numbers or sebum excretion was demonstrated at any sites including the ALA-PDT site. Conclusions, ALA-PDT is capable of clinically improving acne. An alternative mode of action for ALA-PDT other than direct damage to sebaceous glands or photodynamic killing of P. acnes is suggested from the results of this study. [source] | ||||||||||