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Acne Classification and Disease Burden

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Plewig and Kligman´s Acne and Rosacea

Abstract

Nosology does not rank high among the interests of acne researchers. Yet the lack of a common international standard for classifying and grading the severity of acne has been a distressing source of confusion and controversy. The result is that epidemiological data and classifications from different sources cannot be compared because the criteria are different. This adversely affects every field of investigation, for example, surveys concerning the prevalence of acne in different countries. At present we have no definite information about whether acne is more prevalent in meat eaters than in vegetarians, in cold climates compared with warm ones, in different ethnic groups, etc. What dermatologists may classify as severe acne in Japan might be considered mild by American dermatologists.

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Bibliography

Acne Classification and Grading

  • Allen BS, Smith JG Jr. Various parameters for grading acne vulgaris. Arch Dermatol. 1982;118:23–5.

    Article  CAS  Google Scholar 

  • Burke BM, Cunliffe WJ. The assessment of acne vulgaris – the Leeds technique. Br J Dermatol. 1984;111:83–92.

    Article  CAS  Google Scholar 

  • Cook CH, Centner RL, Michaels SE. An acne grading method using photographic standards. Arch Dermatol. 1979;115:571–5.

    Article  CAS  Google Scholar 

  • Doshi A, Zaheer A, Stiller MJ. A comparison of acne grading systems and proposal of a novel system. Int J Dermatol. 1997;36:416–8.

    Article  CAS  Google Scholar 

  • Dréno B. Assessing quality of life in patients with acne vulgaris: implications for treatment. Am J Clin Dermatol. 2006a;7:99–106.

    Article  Google Scholar 

  • Kang S, Lozada VT, Bettoli V, et al. New atrophic acne scar classification: reliability of assessments based on size, shape, and number. J Drugs Dermatol. 2016;15:693–702.

    Google Scholar 

  • Lucky AW, Barber BL, Girman CJ, et al. A multirated validation study to assess the reliability of acne lesion counting. J Am Acad Dermatol. 1996;35:559–65.

    Article  CAS  Google Scholar 

  • Motley RJ, Finlay AY. How much disability is caused by acne? Clin Exp Dermatol. 1989;14:194–8.

    Article  CAS  Google Scholar 

  • O’Brien SC, Lewis JB, Cunliffe WJ. The Leeds revised acne grading system. J Dermatol Treat. 1998;9:215–20.

    Article  Google Scholar 

  • Parish LC, Witkowski JA. The acne scoreboard. Int J Dermatol. 1978;17:490–1.

    Article  CAS  Google Scholar 

  • Petit L, Zugaj D, Bettoli V, et al. Validation of 3D skin imaging for objective repeatable quantification of severity of atrophic acne scarring. Skin Res Technol. 2018;24:542–50.

    Article  CAS  Google Scholar 

  • Petukhova TA, Foolad N, Prakash N, et al. Objective volumetric grading of postacne scarring. J Am Acad Dermatol. 2016;75:229–31.

    Article  Google Scholar 

  • Report of the Consensus Conference on Acne Classification. Washington, DC, March 24 and 25, 1990. J Am Acad Dermatol. 1991;24:495–500.

    Google Scholar 

  • Samuelson JS. An accurate photographic method for grading acne: initial use in a double-blind clinical comparison of minocycline and tetracycline. J Am Acad Dermatol. 1985;12:461–7.

    Article  CAS  Google Scholar 

  • Shalita AR, Leyden JJ, Kligman AM. Reliability of acne lesion counting. J Am Acad Dermatol. 1997;37:672.

    Article  CAS  Google Scholar 

  • Tan JK, Jones E, Allen E, et al. Evaluation of essential clinical components and features of current acne global grading scales. J Am Acad Dermatol. 2013;69:754–61.

    Article  Google Scholar 

  • Tan J, Frey MP, Knezevic S, et al. The relationship between dermatologist- and patient-reported acne severity measures and treatment recommendations. J Cutan Med Surg. 2015;19:464–9.

    Article  Google Scholar 

  • Witkowski JA, Parish LC, Guin JD. Acne grading methods. Int J Dermatol. 1980;116:517–118.

    CAS  Google Scholar 

Disease Burden of Acne and Quality of Life

  • Barnes LE, Levender MM, Fleischer AB Jr, Feldman SR. Quality of life measures for acne patients. Dermatol Clin. 2012;30:293–300.

    Article  CAS  Google Scholar 

  • Dréno B. Assessing quality of life in patients with acne vulgaris: implications for treatment. Am J Clin Dermatol. 2006b;7:99–106.

    Article  Google Scholar 

  • GBD 2013 DALYs and HALE Collaborators, Murray CJ, Barber RM, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet. 2015;386:2145–91.

    Article  Google Scholar 

  • Hayashi N, Miyachi Y, Kawashima M. Prevalence of scars and “mini-scars”, and their impact on quality of life in Japanese patients with acne. J Dermatol. 2015;42:690–6.

    Article  Google Scholar 

  • Karimkhani C, Dellavalle RP, Coffeng LE, et al. Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol. 2017;153:406–12.

    Article  Google Scholar 

  • Md ZAL. Psychosocial issues in acne management: disease burden, treatment adherence, and patient support. Semin Cutan Med Surg. 2015;34(5 Suppl):S92–4.

    Google Scholar 

Excoriations in Acne

  • Bach M, Bach D. Psychiatric and psychometric issues in acne excoriée. Psychother Psychosom. 1993;60:207–10.

    Article  CAS  Google Scholar 

  • Fruensgaard K. Psychotherapeutic strategy and neurotic excoriations. Int J Dermatol. 1991;30:198–203.

    Article  CAS  Google Scholar 

  • Gieler U, Consoli SG, Tomás-Aragones L, et al. Self-inflicted lesions in dermatology: terminology and classification–a position paper from the European Society for Dermatology and Psychiatry (ESDaP). Acta Derm Venereol. 2013;93:4–12.

    Article  Google Scholar 

  • Gupta MA, Gupta AK, Schork NJ. Psychosomatic study of self-excoriative behavior among male acne patients: preliminary observations. Int J Dermatol. 1994;33:846–8.

    Article  CAS  Google Scholar 

  • Gupta MA, Gupta AK, Schork NJ. Psychosomatic correlates of self-excoriative behavior among women with mild to moderate facial acne vulgaris. Psychosomatics. 1996;37:127–30.

    Article  CAS  Google Scholar 

  • Gupta MA, Vujcic B, Gupta AK. Dissociation and conversion symptoms in dermatology. Clin Dermatol. 2017;35:267–72.

    Article  Google Scholar 

  • Kenyon FE. Psychosomatic aspects of acne. Br J Dermatol. 1966;78:344–51.

    Article  Google Scholar 

  • Khumalo NP, Shaboodien G, Hemmings SM, et al. Pathologic grooming (acne excoriee, trichotillomania, and nail biting) in 4 generations of a single family. JAAD Case Rep. 2016;2:51–3.

    Article  Google Scholar 

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Plewig, G., Melnik, B., Chen, W. (2019). Acne Classification and Disease Burden. In: Plewig and Kligman´s Acne and Rosacea. Springer, Cham. https://doi.org/10.1007/978-3-319-49274-2_6

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  • DOI: https://doi.org/10.1007/978-3-319-49274-2_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49273-5

  • Online ISBN: 978-3-319-49274-2

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