Understanding Of Clinical Presentation, Emotional Impact And Lifestyles Factor Correlated With Acne In Chinese Patients

Background:Acne vulgaris remains to be one of the most common diseases afflicting humanity. It is the skin disease most commonly treated by physicians. Due to different genetic background and lifestyle, the prevalence and risk factors of acne are unlikely consistent. These factors are considered to be relevant to the course of disease; however, limited research has evaluated them among people with acne in the same racial and ethnic group.Objective:To describe various features of facial acne, to evaluate the correlation of clinical presentation, behaviors, and associated factors in the severity of acne among Chinese patients.Method:Non-interventional, retrospective, observational study was carried out to evaluate the clinical characteristics and lifestyle factors associated with acne in patients at a dermatology visit for acne. Acne severity was assessed by picture taken with VISIA and questionnaire including medical history, disease evolution, lifestyle habits, previous treatments, skin care and quality of life. Cross tabulation, chi square and regression analysis test were used to find the correlation and P< 0.05 was considered to be the statistically significant value.Results:A total of 100 patients participated in this study,63 women and 37 men.33% had mild,47% subjects had moderate, and the rest had severe to very severe acne.61% subjects reported prior treatment, however only one third of them were satisfied with the treatment results. Majority of subjects (97%) had acne involving multiple facial zones (cheeks, mandibular, forehead, temples) with a spectrum of acne severity similar in both adults and adolescents. Mixed facial acne (both inflammatory and non inflammatory lesions present) was the most common presentation.37% subjects reported back body involvement. GAGS severity ranging from 33% mild,47% moderate,12% severe and 8% very severe. Mean daily stress was 3.64, which was interpreted as mild stress. Psychological job stress was reported more than physical job stress (68.75% vs. 31.25%), and more severe acne was seen among those with psychological stress (75% vs.25%). Erythema, PIH, hyperseborrhoea, scars (mainly atrophic) presented in most of the subjects. Family history, un-daily moisturizer and sunscreen use significantly associated with more severe acne (P> 0.05) while other factors were not significantly associated (P> 0.05). Patients with more severe acne tend to have higher emotional scale score of Skindex-29, yet there was no association between acne severity and emotional scale score of Skindex-29.Conclusions:The study represents an objective assessment of the facial distribution of acne lesions in Chinese patients presenting to our dermatology clinic. Majority of the data indicates that the acne distribution in adults is similar to that in adolescents. Adolescent acne tends to affect men while adult acne tends to affect women. Adolescent acne is more likely caused by hereditary factors, while adult acne is more likely cause by lifestyle factors. Family history of acne, un-daily use of moisturizer and sunscreen were significantly associated with acne severity.