Cardiff Acne Disability Index Score Research Articles

Comparative Efficacy Between Intense Pulsed Light Narrow Spectrum and Broad Spectrum in the Treatment of Post-Acne Erythema (PAE).

Post-acne erythema (PAE) is one of the most common physical sequelae of acne regression, PAE can resolve spontaneously, but in some patients it may last for years. This study aimed to evaluate the efficacy and safety of narrow and broad spectrum filters of intense pulsed light (IPL) for the treatment of PAE. This prospective study evaluated 60 patients with PAE for at least 6 months, assigned equally to three groups: 1st group received narrow-spectrum with vascular filter (530-650 nm and 900-1200 nm), 2nd group received broad-spectrum with (560/590-1200 nm) filters, the appropriate adjustments were made according to patient's skin colour. Every patient received four sessions one month apart. 3rd group is blank control group did not receive any treatment. CAT (CEA (Clinical Erythema Assessment), Area, and Telangiectasia) used to grade clearance of PAE before and after treatment, Investigators Global Assessment (IGA) used to assess the improvement score after the treatment, and Cardiff Acne Disability Index (CADI) used to evaluate the impact of PAE on patients' Quality of Life (QoL). Self-satisfaction scale completed at the follow-up. Adverse events and acne relapse were recorded. A significant decrease of CAT score in vascular group (P<0.05). IGA scale showed significant improvement after vascular treatment. A significant decrease in CADI (P<0.05) after vascular treatment. Patient satisfaction was higher in vascular group than control and blank control groups. Acne relapse observed in control and blank control groups (40% and 15%, respectively).10% of patients showed pigmentation, 15% had blisters after 590 nm treatment. IPL vascular filter (530-650 nm and 900-1200 nm) have efficacy in the treatment of PAE. CADI score, patient satisfaction, and acne relapse were significantly better after vascular narrow spectrum treatment than broad-spectrum treatment.

Translation, Cultural Adaptation and Validation of Cardiff Acne Disability Index in Nepali Language.

Acne causes significant impairment in the quality of life of patients, but clinicians in Nepal lack a simple validated tool to measure the psychological side of acne. We planned to translate and validate Cardiff Acne Disability Index, a five item questionnaire into Nepali language to address this need. A linguistic translation with semantic equivalence to the original English language Cardiff Acne Disability Index was achieved through standard forward and backward translation into Nepali language. All eligible patients were requested to fill the Nepali translated version of both Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires. Reliability and validity of the newly translated questionnaire were established, based on statistical analyses of factor structure, item correlations and concurrent correlations. This validity study included 94 patients with male: female ratio of 1:3.27 and mean age 21.29 (±3.92) years. Reliability analysis revealed a Cronbach's alpha of .72 and mean inter item correlation coefficient of .337. A single factor was extracted on Principal Component Analysis explaining 48.40% of variance. A strong correlation of Cardiff Acne Disability Index scores to the Dermatology Life quality Index score (rs>.7) indicated good concurrent validity. The newly translated Nepali Cardiff Acne Disability Index is a valid tool to measure the impact of acne in Nepalese patients. This short and simple assessment tool will help clinicians understand the patient's perspective of her acne.

Validation of the Cardiff acne disability index and the impact of educational materials in a Romanian cultural adaptation context.

Acne has a high impact on patients being a chronic, common, and visible skin condition. Knowledge regarding treatment improves outcomes. The Cardiff Acne Disability Index (CADI) is commonly used in clinical practice for quality-of-life assessment. It has been validated in many languages, however, not in Romanian. To validate the Romanian adaptation of the CADI and educational materials for acne patients. A 12-week prospective cross-sectional Web-based study, including 3rd- to 5th-year medical students attending our university was conducted. We obtained permission from the CADI copyright owner and performed the steps of the standardized translation process. The Romanian CADI adaptation was delivered online in a test-retest setup, during which participants were offered acne educational materials and completed a knowledge evaluation questionnaire. A total of 95 complete answers were analyzed. The Romanian CADI adaptation showed good internal consistency, with Cronbach's α= 0.807 in the first application and Cronbach's α= 0.839 in the second. High test-retest reliability was observed, with interclass correlation coefficient ICC=0.987 and Spearman's rank correlation coefficient rs =0.970 for the overall CADI scores between the two administrations. The mean baseline score in the knowledge evaluation questionnaire was 15.52 points (±1.556), with a statistically significant improvement after exposure to the educational material (Z=-7.207, p< 0.001). This material was considered useful or very useful by 78(82.8%) participants. Romanian acne patients can benefit from CADI, a reliable and disease-specific tool for quality-of-life evaluation, together with validated, guideline-aligned educational material in their language.

Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients.

IntroductionPost-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH.MethodsThis retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4–6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections.ResultsOn the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up.ConclusionIPL is an effective and safe treatment for acne-related PIE and PIH.

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

Background and AimsIt 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.MethodsBetween 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.ResultsNo 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).ConclusionsThis 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.

“THE STUDY OF CORRELATION OF SEVERITY OF ACNE VULGARIS AND ITS IMPACT ON QUALITY OF LIFE AMONGST MEDICAL STUDENTS IN WESTERN MAHARASHTRA”

Background : Acne vulgaris is one of the most common skin diseases amongst teenagers and young adults. affecting all ethnicities and races and has a considerable impact on quality of life. Aim and objectives : The study was undertaken to observe the clinical prole of acne vulgaris and its impact on quality of life amongst young adolescents using Cardiff Acne Disability Index (CADI) . Materials and methods : It was a hospital based cross sectional, questionnaire based study. A total of 156 medical students were involved in this study. Their clinical acne grading was done using Global Acne Grading System and its impact on quality of life was compared using Cardiff Acne Disability Index (CADI). Results : The study group included 156 students with male to female ratio of 1.29 : 1. According to Global Acne Grading System, 73.07% of participants had mild acne (1-18). The median CADI score is found out to be 4, which indicates mild psychological impact of acne on quality of life. The most common aggravating factor was exam stress (70.51%) in our study. Conclusion : There was low psychological impact of acne on quality of life amongst the study population owing to its mild clinical presentation. Global Acne Grading System and Cardiff Acne Disability Index (CADI) are the simple tools that can be incorporated in the routine management of patients with acne, in order to assess the severity of acne and its impact on quality of life.

IMPACT OF ACNE VULGARIS ON A PERSON’S QUALITY OF LIFE AND IT’S CORRELATION WITH THE CLINICAL SEVERITY PRE AND POST-DRUG THERAPY

Objective: The aim of the study is to assess the therapeutic efficacy of drugs used in acne vulgaris by measuring the severity of acne using the Global Acne Grading System score (GAGS) and Cardiff Acne Disability Index (CADI) questionnaire score pre and post-drug therapy. Methods: The present study was conducted in the Department of Dermatology after getting approval from the Institutional Ethics Committee (No MC/190/2007/Pt1/MAR-2019/PG/123) dated 10/04/2019. It was an observational study for a period of 1 y. 172 patients were enrolled in the study. Patients were divided into 4 grades depending on their clinical manifestation. The severity of acne vulgaris and the quality of life were measured using the GAGS scale and the CADI questionnaire, respectively at the first visit and at the follow-up visit in all the grades of acne vulgaris. A correlation was done between the GAGS and the CADI score at the follow-up visit in all grades of acne. Results: It was observed that the GAGS score and the CADI score was significantly improved at the F/U visit (p&lt;0.05) as compared to baseline in all the 4 grades of acne. A correlation between GAGS score and QoL using CADI scale was done using Pearson Parametric Correlation Test. In none of the groups, the correlation was significant (p&gt;0.05). Conclusion: We can conclude from our study that following treatment with drugs, the clinical severity of acne decreased and there was also a significant improvement in the quality of life of patients.

Correlation study between clinical classification and disability index in a holistic evaluation of acne severity and impact in Turkey.

This study provides a comparison between disease severity observed by inspectors and the disease burden assessed by patients is scanty in acne study. In a multicenter prospective hospital-based study, modified Comprehensive Acne Severity Scale (mCASS) and Cardiff Acne Disability Index (CADI) were employed to grade disease severity and to determine the quality of life, respectively. The average of the mCASS and CADI scores, with range at 0-25, was termed as Acne Severity and Impact Grading System (ASIG). In 1331 evaluated patients (mean: 21,51±4,93 years), including 306 men and 1025 women, an overall significant, positive correlation was found between ASIG and mCASS (r=0.862), or CADI (r=0.686), respectively (P=0.001 each). Adult women with back acne and adolescent with décolleté expressed greater concern (higher CADI) than the clinical severity (lower mCASS). The overall prevalence of acne in décolleté area, including neck, was 32.3%. Discrepancies in the acne severity between self-perception and objective evaluation exist in certain subgroups of patients. Décolleté acne deserves special attention in clinical assessment.

Use of Complementary and Alternative Medicine among Patients with Acne Vulgaris and Factors Perceived to Trigger the Disease: A Multicentre Cross-Sectional Study with 1571 Patients.

Acne vulgaris (AV) is among the common skin diseases for which patients refer to complementary and alternative medicine (CAM). To investigate the approaches to CAM methods and factors believed to increase the disease in 1,571 AV patients. The sociodemographic characteristics of the patients and disease severity according to the Food and Drug Administration criteria were recorded. The Cardiff Acne Disability Index (CADI) was used to assess the impact of acne on the patient's life and the history of CAM use was noted. The patients also listed the factors that they thought worsened their disease and reported their gluten-free diet experiences. Of all the patients, 74.41% had a history of using CAM methods. CAM use was significantly higher in women, patients with severe AV, those with a higher CADI score and non-smokers. As a CAM method, 66.37% of the patients reported having used lemon juice. The respondents most frequently applied CAM methods before consulting a physician (43.94%), for a duration of 0-2 weeks (38.97%). They learned about CAM methods on the internet (56.24%) and considered CAM methods to be natural (41.86%). The patients thought that food (78.55%) and stress (17.06%) worsened their disease. They considered that the most common type of food that exacerbated their symptoms was junk food (63.84%) and a gluten-free diet did not provide any benefit in relieving AV (50%). Physicians need to ask patients about their CAM use in order to be able to guide them appropriately concerning treatments and applications with a high level of evidence.

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

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. 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. 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. 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. 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.

The Cardiff Acne Disability Index

British Journal of DermatologyVolume 185, Issue 4 p. e161-e161 Plain Language Summary The Cardiff Acne Disability Index First published: 04 October 2021 https://doi.org/10.1111/bjd.20671AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Linked Article: Abdelrazik et al. Br J Dermatol 2021; 185:711–724. The Cardiff Acne Disability Index (CADI) is a questionnaire that measures the impact of acne on teenagers and young adults. It is used by doctors and researchers around the world. This study, from the UK, summarizes the published information on the use of the CADI, from 1992 to 2020. This may help potential users decide if the CADI is suitable for their needs. Published studies were searched using several databases in order to ensure all relevant studies were identified. Ninety-six studies reporting the use of the CADI were found and analysed. The CADI has been used in 44 different countries and has been translated into 25 languages. Twenty-nine studies used the CADI to see how well a particular acne treatment works. Fourteen studies examined how consistent CADI scores were when the same participants retook the questionnaire after a period of time. Fifty-seven studies have compared CADI scores with other measures to identify how similar they were. Five studies investigated the relationship of the questions within CADI. Overall, the CADI was found to be trustworthy at measuring the impact of acne. However, no studies have yet calculated the smallest CADI score change required for the patient to have experienced a positive benefit from treatment. The authors of CADI have also rephrased one of the questions to ensure that it is appropriate for all individuals. Volume185, Issue4October 2021Pages e161-e161 RelatedInformation

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.

Quality of life in Montenegrin pupils with acne.

BackgroundAcne is a common skin disease that can affect a person’s quality of life (QoL), self-esteem, and mood in an adverse manner. The aim of the current study was to assess QoL among Montenegrin pupils with acne.MethodsThis cross-sectional survey was conducted over October and November 2020 in four randomly selected secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a short questionnaire which included questions on age, sex, presence of acne, and for those with acne their duration and location, visits to doctors, presence of any other coexisting skin disease, and family history of acne. Only pupils who self-reported acne were asked to complete the Children’s Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI).ResultsSelf reported acne were presented in 49.8% (249/500) of all pupils. The mean CDLQI score of the total sample was 4.27 ± 5.13. Overall, the CDLQI domains that were most affected by acne were symptoms and feelings (mean score 1.49 ± 1.43), leisure (mean score 0.94 ± 1.72), and treatment (0.66 ± 0.79). The mean total CADI score was 3.53 ± 3.11 which was higher in girls (4.07 ± 3.11) than in boys (2.90 ± 3.00). There was good correlation between the two questionnaires (Rho = 0.76; P < 0.01). According to multiple linear regressions, higher overall CDLQI score was found in pupils with acne who reported other skin diseases, while girls, pupils who reported both acne on face and back, and who had any concomitant skin disease had higher CADI total score.ConclusionsAcne affects QoL of young adolescents in Montenegro with greater impact in girls. Our findings should point out the importance of timely diagnosis, treatment, and education of adolescents with acne.

A cross-sectional study on the assessment of dermatology life quality index among the adolescents and young adults with acne vulgaris in south Indian population

Acne vulgaris is one of the most common dermatoses involving chronic inflammation of hair follicles and their accompanying sebaceous gland. Depending up on the grade of the disease severity, it might have a psychological impact on any patient. There is a very few studies on the assessment of dermatology life quality index among patients with acne vulgaris in south India. Proper awareness and early intervention regarding the psychiatric sequel of acne can benefit the outcome of patients. Materials and Methods: This is a hospital based prospective cross-sectional questionnaire study done on acne vulgaris patients attending the dermatology outpatient department in a tertiary care hospital in south Kerala. QoL was measured using both acne specific [Cardiff Acne Disability Index (CADI)] questionnaire and skin disease specific [Dermatology Life Quality Index (DLQI)] questionnaire. Results: Among the patients assessed with DLQI questionnaire, 82.9% had impaired quality of life and 94.3% as assessed with the CADI. The mean CADI score was 5.8 and the mean DLQI score was 6.97. The impact of DLQI was more among adolescent age group than among young adults. Conclusion: Acne vulgaris is a chronic inflammatory disease associated with increased likelihood for psychological burden in society especially among adolescent age group. It is vital for the dermatologist to incorporate quality of life index measurement when treating acne vulgaris patients to provide better emotional care and appropriate counselling. Keyword: Acne, DLQI, QOL.

Homeopathic Treatment of Acne Vulgaris: An Open, Single-Arm, Non-Comparative Study

Abstract Background Acne is often treated at homeopathic clinics in India based on existing literature without using any measurable parameters and the outcomes are seldom reported, hence this study. Objective To evaluate the effects of homeopathy on the treatment of acne using specific outcome measures related to severity and disability. Methods It is an open, single-arm, non-comparative study undertaken at a clinic located in rural India using individualised homeopathy. Global Acne Grading System (GAGS) scores and Cardiff Acne Disability Index (CADI) scores were analysed at baseline and post medication at 3 and 6 months using one-way repeated measure analysis of variance (ANOVA) in Statistical Package for the Social Sciences (SPSS) version 19 to assess the outcomes of intervention. Results Eighty-four patients enrolled in the study were analysed under modified intention to treat approach. Nat-m (n = 14), Calc-s (n = 14), Sulph (n = 13), Kali-br (n = 10) and Hep-s (n = 9) were the most frequently used remedies. Significant differences were found in the severity of the disease and quality of life (QoL) from baseline to 6 months in terms of GAGS (mean difference, 15.47; standard error [SE], 0.69; 95% confidence interval [CI], 13.79–17.16; p &lt; 0.001) and CADI (mean difference, 6.94; SE, 0.33; 95% CI, 6.12–7.75; p &lt; 0.001) scores. A one–way repeated measures ANOVA was calculated and significant effects were found for GAGS scores (Wilks's lambda = 0.142; F [2, 82] = 248.50; p &lt; 0.001; effect size = 0.748) and CADI scores (Wilks's lambda = 0.159; F [2, 82] = 217; p &lt; 0.001; η2 = 0.786) at baseline and 3 and 6 months post medication. There was a positive correlation between the GAGS and CADI: r = 0.585, n = 84, p &lt; 0.001. Conclusions Acne can be effectively treated at homeopathic clinics along with improvement in QoL of patients. Increase in severity of acne was associated with worsening of QoL. Further pragmatic studies with comparative cohort is desirable.

Pharmacoeconomic analysis of different therapeutic regimens prescribed to ACNE patients coming to out-patient department (OPD) of dermatology, venereology and leprosy in tertiary care hospital of northern India

Background: Acne is a cosmetic disease with long treatment duration and expenditure. Therefore, this study was performed to evaluate pharmaoeconomic analysis of different acne treatment in northern population. Materials and Methods: It was a prospective observational study for a period of nine months. A total of 60 patients suffering from mild to moderate acne were enrolled and randomly divided into three groups of 20 each categorized as treatment A, treatment B and treatment C. The study tool used were case record form, Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI). Results: In a total of 60 acne patients, 1:1 ratio of male to female was observed. Maximum number of patients (50%) fell in the age group 21-30 yrs. Improvement in severity of acne was highest in group B. The minimum cost per unit was observed in treatment A group (rupees 73 for 15 gm). Large cost variation was observed in treatment B (rupees 178.15, with a range 76-254.15). The Mean+SD of total cost of therapy for duration of three months was observed to be lowest for treatment B (526.57+223.32). For reduction in GAGS score the Mean+SD of treatment B was found to be the most effective (20.75+4.36). The Mean+SD scores for Average cost effectiveness ratio (ACER), was found to be lowest for treatment B (28.47+19.76). This ACER analysis reflected treatment B as most cost effective. Incremental cost effectiveness ratio (ICER) of treatment A as compared to treatment B was -1.67 while that of treatment C as compared to treatment B was -202.98. This ICER analysis also reflected treatment B as the most cost effective. Mean (DLQI) score and mean CADI score was lowest in treatment group B at third visit. Conclusion: Pharmacoeconomic analysis helps to find disease treatment that is cost economical and equally effective.

How to Increase Adherence and Compliance in Acne Treatment? A Combined Strategy of SMS and Visual Instruction Leaflet

Introduction: Acne is a common skin disease with important psychosocial impact. Often inadequate compliance affects the efficacy of the therapy. Because of emerging use of mobile and electronic health technology, the recent literature evaluated the helpfulness of the tools in medication adherence. The first goal of our study was to evaluate the adherence to therapy with topical adapalene 0.3%/benzoyl peroxide (A-BPO) 2.5% in different groups of patients who received explicative information supported by different strategies. The second goal was to evaluate the patient’s quality of life and skin parameters. Materials and Methods: We enrolled 126 subjects with mild to severe acne vulgaris. They were randomized into 3 groups of 42 patients each and applied daily topical A-BPO (0.3%, 2.5%) for 12 weeks. The first group (G1) was trained on the gel application by an explicative leaflet. The second group (G2) received the same instructions as group 1 and a daily SMS to remind them of the application of the product. The third group (G3) only received standard instructions. Evaluations were performed at the beginning of treatment (T0) and after 12 weeks (T1): assessment of acne severity using the Investigator’s Global Assessment (IGA) Scale for Acne Severity, quality of life by the Cardiff Acne Disability Index (CADI) and the Patient-Doctor Relationship Depth-of-Relationship Scale (PDRDS), skin pH, grade of hydration and adherence to treatment with a 7-day recall calendar were also measured. Results: After 12 weeks of therapy, we observed a reduction in IGA in all groups confirming the clinical efficacy of the product. In the multiple comparison analysis of IGA score reduction, a significant difference was found in G2 versus G1 and G2 versus G3, while the G1 versus G3 comparison was not statistically significant. However, the leaflet group (G1) showed better results compared to the no-leaflet group (G3). Supporting these data, we observed that adherence days correlated positively with the improvement of the single parameters. Moreover, we observed that SMS and leaflet groups had a greater improvement in quality of life evaluated by CADI and PDRDS scores. Conclusions: According to our data, this experimental setup based on text message service and leaflet service is inexpensive and easy to use. Physicians could consider using these items in their practice to enhance patient adherence and satisfaction as well as treatment outcome.

A Real-Life, International, Observational Study Demonstrating The Efficacy Of A Cosmetic Emulsion In The Supportive Care Of Mild-To-Moderate Facial Acne.

PurposeCosmetic emulsions are increasingly being used as supportive care products to alleviate the severe side effects and improve the clinical outcomes associated with conventional acne treatments. The objectives of this study were to determine, in a real-life setting, the global effectiveness of an emulsion with antiseborrheic, keratolytic and anti-Propionibacterium acnes activities as an adjunct to anti-acne therapy, and to evaluate the effect of the product on acne severity, noninflammatory and inflammatory lesions, hyperseborrhea, skin irritation and patient quality of life (QoL). Tolerance of the product was also assessed.Patients and methodsThis international observational study involved 3960 patients aged 12 years and over with mild-to-moderate acne. The conventional acne prescriptions for these patients were either initiated at inclusion or were reviewed. Reviewed prescriptions may have been left unchanged, switched, or an addition made to ongoing treatment. At inclusion, participants were instructed to apply the cosmetic product daily for 2–3 months in combination with their medical acne treatment.ResultsAfter 2 to 3 months of use, the combined therapy resulted in moderate-to-large improvements in acne in over 75% of the patients whose acne prescriptions were left unchanged (n=859). The combination treatment led to an improvement in acne severity (−38.3% change in the mean investigator’s global assessment score; p<0.0001) and QoL (−38.3% change in the mean Cardiff acne disability index score; p<0.0001), and reduced noninflammatory and superficial inflammatory lesions (−35.3% and −47.0%, respectively; p<0.0001), hyperseborrhoea (−40.6%; p<0.0001) and skin irritation (−37.2%; p<0.0001). Tolerance was very good.ConclusionUse of the cosmetic emulsion combined with conventional acne therapy significantly improved clinical outcomes and patient QoL, and was very well tolerated. The combined therapy may have improved patient satisfaction, leading to improved patient adherence and higher rates of therapeutic success.

Akne vulgaris hastalarının değerlendirilmesi için hangi yaşam kalite ölçeği kullanılmalıdır? CADI ya da DYKİ? Bir prospektif çalışma

Aim: Acne vulgaris is one of the most common diseases that affects quality of life. While the Dermatology Life Quality Index (DLQI) is the most frequently used life quality index for dermatologic disorders, the Cardiff Acne Disability Index (CADI) is an acne-spesific quality of life scale. The aim of this study was to determine which scale should be more appropriate and practical to evaluate the quality of life in acne patients and to compare the differences between two scales.Methods: Acne scores of 273 patients who were admitted to the dermatology outpatient clinic between December 2015 and November 2016 were determined by the Global Acne Grading System (GAGS) (range 0 to 44). The DLQI (range 0 to 30) and CADI scores (range 0 to 20) were calculated to evaluate the effect of patients' quality of life.Results: The mean GAGS score of the patients was 20.3, and the mean of CADI score was 6.1, while the mean of DLQI was 6.0. There was a significant positive correlation between total GAGS score and CADI and DLQI (r=0.639, p&amp;lt;0.001). When the relationship between the distribution of acne lesions and quality of life scales was evaluated; CADI score was significantly higher in the forehead localization group than in the non-forehead localization group (p=0.012), and the CADI and DLQI scores were higher in the upper back group than the group without back localization (p=0.001and p= 0.017 respectively). Conclusion: In our study, it was observed that the DLQI and CADI scales were not superior to each other in evaluating the quality of life in patients with acne. Besides, we think that the effect of quality of life on facial acne cases can be determined more clearly with CADI scale.

Metformin as an adjunct therapy for the treatment of moderate to severe acne vulgaris: A randomized open-labeled study.

Insulin, insulin-like growth factor-1 (IGF-1) and essential amino acids activate the mechanistic target of rapamycin complex 1 (mTORC1), the main nutrient-sensitive kinase. Metformin, through inhibition of mTORC1 may improve acne. A 12-week, randomized, open-labeled study evaluated the efficacy and safety of metformin as an adjunct for moderate to severe facial acne. In total, 84 patients received either oral tetracycline 250 mg bd and topical benzoyl peroxide 2.5% with or without metformin 850 mg daily. Evaluations constituted lesion counts, the Cardiff Acne Disability Index (CADI), metabolic parameters and treatment success rate (Investigators Global Assessment score of 0 or 1 or improvement of two grades). Treatment success rates were higher in the metformin group (66.7% vs. 43.2%; p = .04). The mean percentage reduction from baseline in total lesion counts at Week 12 was greater in the metformin group (71.4% vs. 65.3%; p = .278). The CADI scores showed a greater mean reduction in the metformin group (4.82 vs. 4.22; p = .451). Metformin was equally efficacious in improving acne in lean and overweight subjects. Gastrointestinal symptoms were noted in 31.7% of subjects on metformin. This study presents favorable data for metformin as an adjunct for acne treatment. Further randomized placebo-controlled studies are required.