Evaluation of acne quality of life and clinical severity in acne female adults

Clear scalp, clear mind: Examining the beneficial impact of dandruff reduction on physical, emotional and social wellbeing

OBJECTIVE

Dandruff is a common scalp condition characterized by the chronic shedding of large clumps of epidermal cells. Alongside negative physical symptoms, dandruff is thought to have a detrimental impact on individuals' mental health. The aim of this study was to determine whether the clinical benefits of using an anti-dandruff shampoo (ADS) will result in improved psychological wellbeing in individuals suffering from dandruff. Further, this study aimed to investigate whether this improvement would manifest in changes in self-esteem and confidence behaviours.

METHODS

A 4-week dandruff reduction intervention was implemented using a Piroctone Olamine ADS formulation. The control group continued to use their non-ADS. Self-evaluation metrics, including the Scalpdex, State Self-Esteem Scale and self-perceived hair and scalp characteristics questionnaires, were employed to measure changes in self-perceptions of hair and scalp health and psychological wellbeing. Following this analysis, the dataset was then combined with unpublished internal data of a similar intervention study using a Zinc Pyrithione ADS formulation. A mediation analysis was conducted on the combined data to examine the relationship between dandruff symptoms, emotions, and overall behavioural functioning.

RESULTS

First, the ADS effectively reduced the clinical symptoms of dandruff. Second, Scalpdex scores indicated that the use of ADS, compared to non-ADS, lessened the adverse effects of dandruff on symptom perception and emotional distress. Third, the impact of dandruff on behavioural functioning diminished over time, and measures of confidence, scalp comfort and scalp health improved over time, irrespective of product type. Fourth, there was no change in measures of self-esteem for either shampoo. Subsequently, the mediation analysis revealed that across both studies, ADS treatment improved symptoms, emotional wellbeing, and functioning ratings on the Scalpdex questionnaire. Importantly, it also found that improvements in physical symptoms of dandruff improved behavioural functioning indirectly, via its mediating effect on scalp-related emotional wellbeing.

CONCLUSIONS

This study demonstrated that reducing dandruff's physical symptoms directly enhanced emotional well-being related to scalp and hair, and indirectly improved overall daily functioning. These findings suggest that addressing dandruff symptoms not only increases physical comfort but also positively impacts individuals' mental and emotional health, and their ability to function in their daily lives.

A Prospective Randomized Trial Comparing Quality of Life in Adult Female Acne Treated with Azelaic Acid 15% Gel versus Oral Spironolactone

Introduction

In several countries, recent research has shown an increase in the prevalence of adult female acne (AFA), defined as the acne that appears in women aged over 25. This disease brings some particularities and challenges, such as a greater impact on quality of life (QoL) and chronicity. A negative impact on QoL has been observed, as well as anxiety, depression, anger, low self-esteem, and feelings of embarrassment and frustration.

Purpose

To quantify AFA's impact on QoL and the influence of two dermatological treatments.

Material and Methods

A prospective study including 40 women, aging from 25 to 44 years old, with mild-to-moderate acne was conducted. Participants underwent clinical, laboratory, and photographic evaluations. They were randomized into two treatment groups: group 1 - azelaic acid (AZA) 15% gel twice daily; group 2 - spironolactone (SPIRO) 100 mg/day and treated for 6 months. At baseline and at the end of treatments, a specific QoL questionnaire for acne, already translated and validated for Brazilian Portuguese (Acne-QoL-BR), was applied. It contains 19 questions allotted in four domains. Each item within a domain is scored from 0 to 6. The total score ranges from 0 to 114 and domains are distributed as follows: 0-30 (self-perception), 0-30 (role-emotional), 0-24 (role-social), 0-30 (acne-symptoms). Higher scores reflect better QoL.

Results

The mean age was 32.7 (SD: 5.42); 85% presented persistent acne. After treatment regardless of group, there was a significant improvement in total score and all domains' scores of acne QoL-BR (p < 0.001), with no difference between groups, despite one treatment being topical and the other systemic (p=0.918).

Conclusion

Acne-QoL-BR is a useful tool for quantifying the impact of acne and should be used as an efficacy parameter in clinical trials.

The impact of using the levonorgestrel-releasing intrauterine device on the incidence of acne in adolescents and young women

PURPOSE

To evaluate the impact of levonorgestrel-releasing intrauterine device (LNG-IUD) use on the incidence of acne in adolescents and young women.

METHODS

A narrative review was conducted in PubMed, Embase, Cochrane, and SciELO assessing the incidence of acne in adolescents and young women using LNG-IUD (13.5, or 19.5 mg, or 52 mg). Cohort, cross-sectional studies, clinical trials, and meta-analyses were included, without a date limit. Studies that didn't evaluate women in the age of interest were excluded. Only articles in English were selected.

RESULTS

Nine articles were included in this narrative review. Only clinical trials, cohort studies, and cross-sectional studies were evaluated. Two cross-sectional studies evaluated the incidence of acne in women using any contraceptive methods, with the incidence of acne being 36% in women aged 17 to 47 using LNG-IUD in one study. In another study, acne incidence ranged from 2 to 8% in women using any contraceptive methods, with higher rates in younger women and LNG-IUD users. The incidence of acne varies and participants between 16 to 35 years were more likely to report new acne or worsening of pre-existing acne. In a prospective cohort study of women between 16 and 24 years, acne was a common adverse effect, with 44% in the first year.

CONCLUSION

The data indicate variability in the incidence of acne among LNG-IUD users, with a higher prevalence observed in younger women. Further research should focus on the effects of LNG-IUD on acne in young populations, with rigorous study designs and consideration of previous contraceptive use.

Topical application of bacteriocins from Bacillus subtilis promotes Staphylococcus aureus decolonization in acneic skin and improves the clinical appearance of mild-to-moderate acne

Introduction

Patients with mild-to-moderate acne are frequently colonized by Staphylococcus aureus on their skin, which alters microenvironmental skin conditions and exacerbates disease symptoms. Bacteriocins produced by Bacillus subtilis may act as antimicrobial peptides against Gram-positive bacteria.

Aim

To investigate whether topical application of bacteriocins from B. subtilis could serve as a potential strategy for promoting S. aureus decolonization from acneic skin.

Material and methods

The research product was a cream formulation containing 1% bacteriocins from B. subtilis. First, we conducted a 60-day pilot study on the effect of topically applied bacteriocins from B. subtilis on the absolute abundance of S. aureus in 12 patients with mild-to-moderate acne. Second, we designed an 8-week, uncontrolled, open-label, multicentre clinical study to investigate whether the topical application of bacteriocins from B. subtilis reduces the number of inflammatory and non-inflammatory lesions, as well as Global Acne Grading Scale (GAGS) scores, in 373 patients with mild-to-moderate acne.

Results

At the microbiological level, quantitative PCR showed a decrease in the absolute abundance of S. aureus in acne areas after topical application of the research product for 60 days (-38%, p < 0.001). In the clinical study, the number of inflammatory and non-inflammatory lesions was found to decrease at 8 weeks by 59% (p < 0.001) and 58% (p < 0.001), respectively, compared with baseline. A 56% decrease was observed for GAGS scores.

Conclusions

Topical bacteriocins from B. subtilis can promote S. aureus decolonization in acneic skin, ultimately improving the clinical appearance of mild-to-moderate acne.

The association between acne care provision and quality of life: A cross-sectional survey

BACKGROUND AND AIMS

It has been suggested that professional acne care can be effective not only in reducing clinical signs but also in improving quality of life (QOL). This study aims to reach a better understanding of the association between QOL and professional acne care. The study also investigates other factors that might influence QOL such as age, gender, and acne severity.

METHODS

Between 2019 and 2020, a cross-sectional survey-based study was conducted among 362 acne patients. Data were collected by the Cardiff Acne Disability Index (CADI) and a Global QOL scale. Analysis of covariance (ANCOVA) and post hoc comparisons were conducted to analyze the association between professional acne care and health-related QOL.

RESULTS

No statistically significant differences were found in QOL measured by CADI among patients visiting the four investigated acne caregivers (mean CADI score: dermatologist, 4.49; GPs, 4.42; dermal therapist, 4.07; beautician, 4.20, P = .24). However, the impact of the treatment on the QOL, which was measured by the level of Global QOL improvement before and after care, demonstrated a statistically significant improvement when attending a dermatologist, compared to the care provided by beauticians (Global QOL improvement: dermatologist, 1.50; GP, 1.01; dermal therapist, 1.10; beautician, 0.54, P = .05). Females experienced a more impaired acne-related QOL than males (P = .05), and increased acne severity was associated with a more impaired QOL (P < .05).

CONCLUSIONS

This study delineated factors that influence QOL in acne patients. As the QOL was not associated with the type of caregiver, the greatest QOL improvement before and after care was achieved after medical treatment by the dermatologist. Females and individuals dealing with more severe types of acne experienced a more impaired acne-related QOL. It is recommended to take these factors into account in acne management to optimize professional treatment in line with patient needs.

Quality of life in young adults with acne: Results of a cross-sectional study

BACKGROUND

The impact of acne on quality of life (QoL) may vary between patients from different age groups. There are limited data in the literature on QoL of young adults with acne and acne scars.

OBJECTIVES

To assess the QoL of young adults (age 18 to 25) with acne by using dermatology life quality index (DLQI) and Cardiff acne disability index (CADI), to assess the scores of individual items on DLQI and CADI, and to compare the two scales.

METHODS

In this cross-sectional questionnaire study of 1392 subjects with acne, each subject completed two questionnaires: DLQI and CADI. Mean values of DLQI and CADI, and those of individual items on DLQI and CADI were calculated; t-test was used for testing mean values and Spearman's rho coefficient for correlation between two questionnaires.

RESULTS

Mean DLQI (4.50) and CADI (3.60) scores were low. However, scores were significantly higher in females and in those with acne scars. "Feelings of embarrassment" and "interference with social activities" scored significantly higher for females across both questionnaires. There was no correlation between severity (as well as duration) of acne and HRQoL scores. Spearman's rho coefficient of correlation between DLQI and CADI was 0.71.

CONCLUSIONS

Acne impaired the QoL of young adults, acne scars more so. Females felt worse about their appearance with greater embarrassment and impaired social activities. QoL scores seem to depend on patients' perceptions, which may depend on factors other than objective severity of acne. We found good correlation between the two scales.

Clinical experience and psychometric properties of the Cardiff Acne Disability Index (CADI)

The Cardiff Acne Disability Index (CADI) is a questionnaire designed to measure the quality of life of teenagers and young adults with acne. It has been used clinically and within therapeutic research globally. This review aims to appraise all published data regarding the clinical and research experience of the CADI, its psychometric properties and validation, from its publication in 1992 until September 2020, in a single reference source. A literature search was conducted using MEDLINE via Ovid, PubMed, EBSCOhost, Web of Science and Scopus. All full articles in the English language were included. A total of 96 clinical studies were identified and analysed. The CADI has been used in 44 different countries, including four multinational studies, and has validated translations in 25 languages. Overall, 29 therapeutic interventions have used the CADI, demonstrating its responsiveness to change. The reliability of the CADI has been assessed in 14 studies through test-retest and internal consistency studies. In total, 57 studies have demonstrated aspects of its validity through correlation to other measures, and five studies have investigated the dimensionality of the CADI. There is evidence of high internal consistency, test-retest reliability, responsiveness to change and significant correlation with other objective measures. The minimal clinically important difference and validated score meaning bands have not yet been reported. This information is needed to improve the interpretability of CADI scores for clinical use and in research. The authors of the CADI have also rephrased Question 2 of the measure to ensure inclusivity.

Impact of acne on quality of life in young Pakistani adults and its relationship with severity: A multicenter study

Objectives:

The current study aimed to determine the effect of acne vulgaris on quality of life of young adults and to assess the correlation between acne severity and impairment of quality of life (QOLI).

Methods:

In this multi-center cross-sectional study, 163 young adults with acne vulgaris were assessed for severity and quality of life impairment between December 2016 and May 2017 at three tertiary care hospitals. Cardiff Acne Disability Index (CADI) was used to assess the quality of life while the severity of acne measured by Global Acne Grading System (GAGS). Data were collected on standardized forms, with CADI, GAGS scores, and sociodemographic data and analyzed using SPSS version 9. The quantitative variables were presented as means, median and qualitative variables expressed as frequency and percentages. P-value ≤0.05 was considered as statistically significant.

Results:

Out of 163 patients enrolled in this study, the mean age was 21.6 ± 4.9 years and 124 were females and 39 males. In mild QOLI, 56 (87.5%) cases were affected with mild, 11 (13.4%) with moderate and 1 (1.5%) case had severe acne. While, in moderate QOLI, 8(12.5%) cases were of mild, 60 (73.2%) were moderate and 6 (35.3%) cases affected with severe acne. The severe impairment of QOL noted in 11 (13.4%) moderate and 10 (58.8%) severe acne cases. The relationship between sex was statistically significant, (P<0.001). The result showed significant correlation between severity of acne vulgaris and the quality of life impairment of these patients (P<0.001).

Conclusion:

This study showed significant correlation between acne vulgaris and quality of life impairment. Cardiff acne disability index has proven to be a reliable tool to assess the quality of life. It is recommended to be used routinely in dermatology clinics to provide tailored treatment to individuals because mild disease may be disproportionately distressing for patients.

Severity of Acne Vulgaris: Comparison of Two Assessment Methods

Purpose

Numerous tools are available to assess acne severity. It is important to have an acceptable and easy to use tool for acne assessment for many reasons, such as initial assessment and follow-ups, clinical trials, and comparisons of clinical studies. The aim was to investigate the agreement between different observers (inter-observer variation) in the evaluation using the Global Acne Grading System (GAGS) and Investigator Global Assessment of Acne (IGA). Besides, to investigate the correlation between the assessment scores and its relation to the quality of life scales Dermatology Life Quality Index (DLQI) and the Cardiff Acne Disability Index (CADI).

Patients and Methods

This was a prospective study. Four investigators involved to evaluate the study subject surveyed 54 patients complaining of acne using IGA and GAGS scores (DLQI and CADI).

Results

A significant relation was seen between GAGS and IGA (Pearson chi-square test p= 0.001), and they demonstrated excellent inter-rater reliability. There was no correlation between IGA and quality of life measures (CADI nor DLQI). However, there was a significant weak correlation between GAGS and CADI.

Conclusion

The two methods for acne severity assessment are reliable, and they are correlated. Quality of life concerning acne is not correlated with the severity of the disease.

Prevalence and psychological impact of Acne vulgaris among female secondary school students in Arar city, Saudi Arabia, in 2018

Background

Acne vulgaris is a common heath problem affecting adolescents with considerable impact on their quality of life.

Objective

To determine the prevalence of Acne vulgaris and its psychological impact among female secondary school students.

Methods

A cross-sectional study was conducted during the period from January to March 2018, among all female secondary school students in 3 randomly selected schools, in Arar city (Saudi Arabia). The participants were clinically examined by a dermatologist to identify acne cases. Dermatological quality of life of acne cases were assessed using an Arabic version of Dermatology Life Quality Index (DLQI). Data collected were analyzed by IBM-SPSS version 20, using Chi-square, Fisher’s Exact test, Mann-Whitney U, and Kruskal Wallis test. P-value ≤0.05 was considered statically significant.

Results

The overall prevalence of Acne vulgaris was 14.3%. It was not significantly affected by age, marital status or nationality of participants. Post inflammatory hyper-pigmentation and scarring were detected in 11.6% and 8.7% respectively. Twenty nine percent of the cases had no impact; 56.3% had small to moderate impact and 14.5% had large effect. The psychological impact was significantly increased with increased severity, presence of acne lesions on face and other sites, presence of hyper pigmentation and scarring (p=0.001).

Conclusion

Acne vulgaris had large impact on quality of life in 14.5% of cases. Students should be counseled and educated on how to deal with this dermatological problem.

Quality of life measurement in acne. Position Paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa

Acne causes profound negative psychological and social effects on the quality of life (QoL) of patients. The European Dermatology Forum S3-Guideline for the Treatment of Acne recommended adopting a QoL measure as an integral part of acne management. Because of constantly growing interest in health-related QoL assessment in acne and because of the high impact of acne on patients' lives, the European Academy of Dermatology and Venereology Task Force on QoL and Patient Oriented Outcomes and the Task Force on Acne, Rosacea and Hidradenitis Suppurativa have documented the QoL instruments that have been used in acne patients, with information on validation, purposes of their usage, description of common limitations and mistakes in their usage and overall recommendations.

Psychosocial Impact of Postinflammatory Hyperpigmentation in Patients with Acne Vulgaris

Background: Acne vulgaris is a common, often socially distressing skin condition primarily seen in young adults. Quality of life studies have shown that people with acne are more introverted with increased social setting anxiety compared to a control group. Unfortunately, patients with acne may have residual postinflammatory hyperpigmentation, amplifying impaired psychosocial effects. Objective: To quantify the impact of postinflammatory hyperpigmentation in patients with acne using a psychometric scale. Design: A clinic-based survey was conducted among US adults with facial acne and postinflammatory hyperpigmentation. Outcomes included age, race, gender, and acne-related quality of life. A board-certified dermatologist rated each patient's acne severity and postinflammatory hyperpigmentation. Setting: Dermatology clinic, Anheuser Busch Institute and Des Peres Hospital, Saint Louis, Missouri. Participants: 48 subjects (25 patients with acne and postinflammatory hyperpigmentation; 23 with acne only). Measurements: Acne Quality of Life survey, dermatologist rating of acne and postinflammatory hyperpigmentation severity. Results: Subjects with postinflammatory hyperpigmentation reported statistically significant poorer mean scores on the Acne Quality of Life survey than subjects with acne only. Sixty percent of patients with postinflammatory hyperpigmentation had a "very markedly" impact to at least one aspect of the Acne Quality of Life survey scale compared to none of the acne only patients. There was no association between provider-reported hyperpigmentation severity and psychosocial impact. No differences in psychosocial impact were noted between males and females. Conclusion: Patients with acne and postinflammatory hyperpigmentation had poorer quality-of-life scores compared to patients with only acne. Having postinflammatory hyperpigmentation with acne negatively impacted self-perceptions and social/emotional functioning, especially in groups.

Prevalence of acne vulgaris and its impact of the quality of life among secondary school-aged adolescents in Sohag Province, Upper Egypt

BACKGROUND

Acne vulgaris is the most common dermatological condition encountered in adolescents.

AIM

It was to determine the prevalence of acne vulgaris and its impact of the quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt.

PATIENTS AND METHODS

This was a cross-sectional study conducted in randomly selected governmental and technical secondary schools in Sohag Province, Upper Egypt. Approval was taken from the scientific research committee of Sohag Faculty of Medicine and also from Ministry of Education. Every student with acne was subjected to full medical history and local examination of head and neck to assess the severity of acne vulgaris. Assessment of the impact of acne vulgaris on their quality of life was carried out using self-reported validated specific questionnaire, the Cardiff Acne Disability Index (CADI).

RESULTS

This study included 994 teenage secondary school students. The overall prevalence of acne vulgaris was 333 (33.5%). The mean age of the students with acne was 16.84±0.87. Acne vulgaris was more common among females than among males (200, 60% vs 133, 40%). The most common form of acne vulgaris was mild 178, 53%, followed by moderate form 135, 41%, and severe form 20, 6%. CADI score was significantly related to the disease grade and it was maximum among those with severe grade, followed by moderate and lastly mild disease grade.

CONCLUSION

Acne vulgaris is a common skin disease and has a valuable impact on quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt.

Quality of life in acne vulgaris: Relationship to clinical severity and demographic data

BACKGROUND

Acne vulgaris is known to impair many aspects of quality of life. However, the correlation of this impairment with clinical severity remains equivocal despite various school, community and hospital-based studies.

AIM

A hospital-based study was undertaken to measure the impairment of quality of life of patients of acne vulgaris and correlate it with the severity of lesions.

METHODS

This was a cross-sectional, questionnaire-based study in a cohort of 100 patients of acne vulgaris attending the outpatient department of our referral hospital. A physician measured the severity of lesions using the global acne grading system, and patients assessed quality of life by completing a questionnaire (Cardiff acne disability index). A correlation of these two was done; some additional correlations were brought out through demographic data collected from the patients.

RESULTS

There was no correlation between the severity of acne vulgaris and an impaired quality of life. Patients who consumed alcohol and/or smoked cigarettes were found to have an impaired quality of life. While the severity of acne progressively lessened in older patients, the impact on quality of life increased.

LIMITATIONS

The sample size was small and there was a lack of guaranteed reliability on the self-reported quality of life.

CONCLUSION

The severity of acne vulgaris does not correlate with impairment in quality of life.

Azelainsäure 20 % Creme: Auswirkung auf Lebensqualität und Krankheitsaktivität bei erwachsenen Patientinnen mit Acne vulgaris

HINTERGRUND

Zur Wirksamkeit von Aknetherapien und deren Auswirkungen auf die Lebensqualität erwachsener Patienten liegen kaum Daten vor. ZIEL: Erhebung der Wirkung von Azelainsäure 20 % Creme (Skinoren^® ) auf Akne-Schweregrad und krankheitsbedingte Lebensqualität.

PATIENTEN UND METHODIK

Nichtinterventionelle Studie bei erwachsenen Patientinnen mit leichter bis mittelschwerer Akne. Wirksamkeitsparameter waren DLQI sowie Akne-Schweregrad im Gesicht, am Dekolleté sowie am Rücken im Gesamturteil des Prüfarztes (IGA-Skala: Grad 1 = annähernd reine Haut; 2 = leichte Akne; 3 = mittelschwere Akne). Visiten waren zu Studienbeginn sowie nach 4-8 und zwölf Wochen geplant.

ERGEBNISSE

Von den 251 eingeschlossenen Patientinnen lag zu Studienbeginn bei 59 %, 31 % bzw. 10 % ein IGA-Grad von 1, 2 bzw. 3 vor; die am häufigsten betroffene Hautpartie war das Gesicht (IGA-Grad 2 oder 3: 79 %). Nach zwölf Behandlungswochen war eine signifikante Besserung der Acne vulgaris im Gesicht (IGA-Grad 0 oder 1: 82 %) sowie auf Dekolleté und Rücken feststellbar. Der mediane DLQI-Wert sank von neun zu Studienbeginn auf fünf nach zwölf Behandlungswochen. Neunzig Prozent der behandelnden Ärzte und Patientinnen beurteilten die Verträglichkeit der Behandlung als sehr gut oder gut.

SCHLUSSFOLGERUNGEN

Die Anwendung von 20%iger Azelainsäure-Creme führt bei erwachsenen Frauen zu einer signifikanten Besserung der Acne vulgaris und der krankheitsbedingten Lebensqualität.

Adapalene-benzoyl Peroxide Gel is Efficacious and Safe in Adult Female Acne, with a Profile Comparable to that Seen in Teen-aged Females

Objectives: To evaluate the efficacy and safety of adapalene 0.1% benzoyl peroxide 2.5% gel in women aged 25 years or older via subgroup analysis of existing Phase 2 and 3 study data. Methods: Meta-analysis of pooled data from three multicenter, randomized, double-blind, vehicle-controlled, parallel-group, clinical trials compared results of treatment with either adapalene 0.1% benzoyl peroxide 2.5% gel or vehicle gel in adult females and teen-aged females. Efficacy assessments included investigator's global assessment and median percent change in acne lesions. Safety assessments included skin tolerability and adverse events. Results: Two hundred fifty-four adult females and 488 teen-aged females were included in the analyses, and baseline characteristics were comparable between subjects receiving adapalene 0.1% benzoyl peroxide 2.5% or vehicle. Both adult females and teen-aged females in the adapalene 0.1% benzoyl peroxide 2.5% arm were significantly more often rated clear/almost clear compared with those in the vehicle arm at Weeks 8 (P=0.016) and 12 (P<0.001); at endpoint, success was achieved in 39.2 percent with adapalene 0.1% benzoyl peroxide 2.5% and 18.5 percent with vehicle. Comparison of the amount of difference between active and vehicle reductions in investigator's global assessment showed that efficacy was similar for adult females versus teen-aged females (20.7% vs. 19.9%, respectively). Adapalene 0.1% benzoyl peroxide 2.5% had a rapid onset of action, with statistically significant reductions in all acne lesion types versus vehicle observed by Week 1. Adapalene 0.1% benzoyl peroxide 2.5% was safe and well-tolerated by adult females with a tolerability profile consistent with that seen in teen-aged females. Conclusions: The once-daily fixed-dose combination product adapalene 0.1% benzoyl peroxide 2.5% is an efficacious, safe, and well-tolerated treatment for adult female acne, with a profile similar to that in teen-aged females.

Psychologic consequences of facial dermatoses

The attractiveness of the human body has always been an important issue in the fields of sociology, psychology, and psychiatry and also in the field of dermatology. In psychodermatology, one often discovers how all these fields intermingle to produce elaborate situations and extreme human difficulties. Perfect skin is widely adored in literature, poetry, and biblical texts, as well as in advertisements, movies, and television. Because in most societies the face is the body part that is visible, imperfections of the skin are also visible; therefore, its flawed appearance bears the potential to become a source of misery to some.

Which factors influence quality of life in acne patients?

BACKGROUND

The factors that impact quality of life in acne patient are not fully understood.

OBJECTIVE

The purpose of this study was to assess the relationship between quality of life with (i) acne severity; (ii) the duration of this cutaneous disease; and (iii) the gender.

METHODS

Leeds scale to quantify acne severity, and Assessment of the Psychological and Social Effects of Acne (APSEA) score to evaluate quality of life were used. An unselected consecutive group of 50 males and 50 females affected by facial acne filled in the APSEA questionnaire during the first visit and after 3 months of treatment.

RESULTS

(i) At the beginning of the treatment, APSEA score correlated with acne severity, but at the end of it, the reduction of APSEA score was less marked than the reduction of acne severity. (ii) Acne duration does not significantly influence APSEA score. (iii) Before treatment, acne severity was comparable between females and males, whereas APSEA score was significantly higher in females than in males.

CONCLUSION

The quality life of acne patients could be influenced by social and emotional factors. The discrepancy of the results reported in literature regarding the correlation of the quality of life with acne severity and duration probably depends on the sensitivity and specificity of the questionnaire used to assess the quality of life. Among the different available scores to measure quality of life in acne patients, in the authors' experience, APSEA score is a valuable one.

Harnessing the power of crowds: crowdsourcing as a novel research method for evaluation of acne treatments

BACKGROUND

Crowdsourcing is a novel process of data collection that can provide insight into the effectiveness of acne treatments in real-world settings. Little is known regarding the feasibility of crowdsourcing as a means of collecting dermatology research data, the quality of collected data, and how the data compare to the published literature.

OBJECTIVE

The objective of this analysis is to compare acne data collected from a medical crowdsourcing site with high-quality controlled studies from peer-reviewed medical literature.

METHODS

Crowdsourced data was collected from 662 online acne patients. Online patients reported data in a Likert-type format to characterize their symptom severity (740 total responses) and their treatment outcomes (958 total responses). The crowdsourced data were compared with meta-analyses and reviews on acne treatment from August 20, 2010 to August 20, 2011.

RESULTS

We compared topical, oral systemic, alternative, phototherapy, and physical acne treatments of crowdsourced data to published literature. We focused on topical tretinoin due to the large number of online patient responses. While approximately 80% of tretinoin users observed clinical improvement after a 12-week treatment period in clinical trials, 46% of online users reported improvement in an unspecified time period. For most topical treatments, medication with high efficacy in clinical trials did not produce high effectiveness ratings based on the crowdsourced online data.

CONCLUSION

While limitations exist with the current methods of crowdsourced data collection, with standardization of data collection and use of validated instruments, crowdsourcing will provide an important and valuable platform for collecting high-volume patient data in real-world settings.

Quality of life in Iranian patients with acne

Acne is a chronic inflammatory disease of pilosebaceous units. Although the acne isnot a life threatening disease, studies have revealed that it has significant effect on self-image and quality of life. The purpose of this paper was to investigate the health-related quality of life in patients with acne in an Iranian context. Dermatology Life Quality Index (DLQI) and Cardiff Acne Disability Index (CADI) were used for measuring quality of life, and severity of acne was measured by Global Acne Grading System (GAGS). The mean (±SD) of DLQI and CADI scores was 6.42 (±4.77) and 5.97 (±2.97), respectively. Acne influenced the quality of life in 51.8% of patients from moderate to very much, and the quality of life was affected by the severity of acne (P < 0.01). Since acne has significant effects on patient's quality of life, the management of patients with acne requires more attention to different aspects of quality of life.