Application Of Non-invasive Skin Testing In The Assessment Of Treatment For Moderate To Severe Acne Vulgaris

Objective:To analyse the clinical characteristics,influencing factors,dermoscopic and high frequency ultrasound characteristics of patients with moderate to severe acne vulgaris before and after treatment,and to explore the value of the application of dermoscopy and high frequency ultrasound in the assessment of the efficacy of moderate to severe acne vulgaris.Methods:In this study,basic information and clinical data were collected from patients with moderate to severe(grades III and IV)acne vulgaris and mild to moderate(grades I and II)acne vulgaris who were treated at the Affiliated Hospital of Guilin Medical College between October 2021 and December 2022,and dermatological(T0),end of week4(T1)and end of week 12(T2)were collected from patients with moderate to severe acne vulgaris who underwent treatment microscopic and high frequency ultrasound skin lesion picture information.Statistical analysis was performed using SPSS 26.0 software.P<0.05 was considered a statistically significant difference.Results:(1)A total of 74 cases of moderate to severe acne vulgaris were included in T0,30 cases(40.54%)in males and 44 cases(59.46%)in females,with a male to female ratio of 1:1.47;the age range was 15 to 35 years,with the largest number of patients aged 18 to 25 years,57 cases in total,accounting for 77.03% of all cases;due to the epidemic,some patients were lost to follow-up,and the number of patients participating in this study to complete T1 and T2 The number of patients in this study was 40 and 30 cases respectively.(2)BMI,mean daily sleep duration,alcohol consumption,skin texture,DLQI,and family history were statistically significant(P<0.05)in moderate to severe versus mild to moderate acne vulgaris.(3)Among the dermoscopic features of moderate-to-severe acne vulgaris before and after treatment,the differences in fried egg-like structures and oil-drop-like structures before and after treatment were statistically significant(P<0.05)at T1,and the differences in background colour and fried egg-like structures before and after treatment were statistically significant(P<0.05)at T2.(4)The study was analysed using the Kappa consistency test to analyse the consistency between Pillsbury grading and SSSA grading before and after treatment,with significant differences in the results between Pillsbury grading and SSSA grading as the duration of treatment increased,at T1 there were 25(62.50%)people with SSSA grading of III,while Pillsbury grading of At T2,there were 8(26.70%)SSSA grade III patients compared to 2(6.70%)Pillsbury grade III patients.(5)High frequency ultrasound measurements of moderate to severe acne vulgaris were statistically significant(P<0.05)before and after treatment for the following reference indicators: number of nodules/cysts,maximum nodule/cyst length,maximum nodule/cyst width,maximum cyst base distance from the body surface,maximum cyst internal hyperecho length,dermal thickness at the maximum cyst,and normal dermal thickness.(6)In this study,the overall DLQI scores tended to decrease after treatment for moderate to severe acne vulgaris,and the differences were all statistically significant(P<0.05).Conclusions:(1)This study suggests that BMI,average daily sleep duration,alcohol consumption,skin texture,DLQI,and family history may be influential factors for moderate to severe acne vulgaris.(2)Dermoscopy is suitable for observing the following features: pale red background,dotted blood vessels,yellowish halo around the hair follicle,fried egg-like structures,oil-drop-like structures,etc.High-frequency ultrasound is suitable for observing the following features: number of nodules/cysts,length and width of the largest nodules/cysts,distance of the base of the largest cysts from the body surface,length of the hyperechoic diameter of the largest cysts,thickness of the dermis at the largest cysts,presence of strong echogenicity(calcified foci)within the cysts,involvement of the fat layer,etc.),whether the fat layer is involved,etc.(3)The combination of dermoscopy and high-frequency ultrasound can provide a more accurate and effective means of assessing the severity and prognosis of moderate to severe acne.