| Objective1.To explore the cognitive status of Chinese acne-afflicted patient and the influence for patients' cognition on their choice of health-seeking behavior,so as to provide a basis for the prevention and treatment of acne.2.Through evaluating the clinical features of acne-afflicted patients to explore the characteristics of patients with different genders and different types,the purpose is to provide evidence for the treatment of acne.Methods1.A self-designed questionnaire was made to survey 16,156 acne patients who have sought the treatment from dermatological departments in 112 hospitals in China.The survey consisted of several parts—the general status of patients,the patients,cognitive status,the condition of skin care and whether the patients would like to choose medical treatment as soon as they are diagnosed with this disease.We analyzed the factors which could impact the cognition of the patients and how cognition affected patients' skin care and medical treatment behavior.We also analyzed the consistency from doctors and patients assessing the severity of acne.The questionnaires were made with double-data-entry by Epidata3.1,and the collected data was analyzed by SPSS20.0 statistical software.Descriptive analysis was used for enumeration data,and logistic regressive method was used for analysis of influencing factors.The consistency of acne severity assessment between doctors and patients was analyzed by chi-square test and Kappa value.2.For 16,156 patients who have sought the treatment from dermatologicaldepartments in 112 hospitals,their lesions were evaluated by the attending physicians to determine the severity and types of acne(adolescent acne,adult persistent acne and adult-onset acne).Then we analyzed the connection among the differences in gender,severity of this disease and types of lesions.The cross table,chi-square test and rank sum test were used to analyze the relationship among the differences in gender,types of acne,the severity of disease and types of lesions.P<0.05 was considered statistically significant.Results1.Analysis of the cognition of patients16,156 patients in total were surveyed in order to know their cognition of acne.The result showed the best knowledge of“acne is a skin disease","this disease not only occurs in the period of adolescence" and "it can be prevented and cured",which accounted for 80.65%,69.16%and 65.49%of the total respectively.However,the awareness of heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72%,42.40%and 18.25%of the total patients separately.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients.The survey found that men,patients with educational level of junior high or even lower educational level,or labor workers or farmers and patients who lack of health education had poor knowledge of the genetic and dietary risk factors for acne;patients with age over 36 or with mild illness had poor knowledge of dietary risk factors for acne,the difference was statistically significant(P<0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice(OR=1.05,P<0.05),and choose functional skin care products(OR=1.30,P<0.05).Analysis of patients' self-evaluation for severity:3,707 cases of mild(22.95%),6,765 cases of moderate(41.87%)and 5,684 cases of severe(35.18%)were self-assessed by patients.2,000 cases of mild(12.38%),11,305 cases of moderate(69.97%)and 2,851 cases of severe(17.65%)was evaluated by the specialists.The consistency of assessment of the severity of acne by doctors and patients was poor(Kappa value is 0.12,Kappa<0.4),which means patients have poor self-cognition on their disease situations.2.Analysis of clinical features of acneThere were 5,882 male(36.41%)and 10,274 female(63.59%)of 16,156 patients in total.Among them,10,741 cases(66.48%)were diagnosed as adolescent acne,and 5,415 cases(33.52%)were diagnosed as post-adolescence acne.Among all post-adolescence acne,3875 cases(23.98%)were diagnosed as adult persistent acne,and 1540 cases(9.53%)were diagnosed as adult-onset acne.The analysis of severity in acne in different genders and types:There was a difference in the distribution of male and female patients in different degrees of severity(P<0.05),and female patients with grade ?-?(mild to moderate)acne were more common,while male patients with grade ?(severe)acne were more common.Which showed the differences in all types of acne,the Incidence rate of ?(severe)grade acne in adult persistent acne and adolescent acne were higher than adult-onset acne(P<0.05).The Analysis of lesions in acne patients of different genders and types of acne:the incidence of nodules/cysts,pitting scars and hypertrophic scars was higher in male.The incidence of comedo,papule and pustule was higher in female,and the difference was statistically significant(P<0.05).There was no statistical difference in the incidence of Post-inflammatory hyperpigmentation(PHI)between male and female.The rates of comedo,papule and PHI in adolescent acne were higher than post-adolescence acne,the difference was statistically significant(P<0.05).Conclusion1.Patients had inadequate awareness of the risk factors for acne such as heredity,high sugar and dairy products.Gender,age,educational level,occupation and health knowledge were factors affecting the cognitive level of patients.Patient's cognitive status would affect their medical behavior and skin care,and there was a phenomenon that patients considered themselves more serious acne.It was suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as effective acne prevention.2.Among the acne patients in China,severe acne had a higher incidence in males,and the skin lesions were commonly found with cyst,pitting scar and hypertrophic scar.Females were more mild to moderate acne,skin lesions are commonly found with comedo,papule and pustule.In addition,the severity of adolescent acne and adult persistent acne were significantly higher than that of adult-onset acne.Comedo,papule and PHI were more frequently found in adolescent.Understanding the clinical characteristics of patients was helpful to develop targeted treatment programs,early intervention and improvement of curative effect of treatment. |
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