Systems for the Grading and Classification of Acne Vulgaris

What systems are most generally used for the classification and grading of acne vulgaris in adolescents (from 11 to 21 years) and young adults?
  • The doctor may find it useful to use a consistent grading or classification level (covering the numbers and types of the lesions of acne as well as disease severity, anatomical sites, and acne scars) to facilitate therapeutic methods and assess response to the therapy.
  • Currently, no universal acne grading/ classification system can be advised.

grading classification acne vulgaris system
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The strength of Recommendation: B Evidence Level: II, III
Acne classification systems may be helpful in patient care. Such systems can assist in the more specific classification of disease, determining suitable treatment options, and monitoring condition during the treatment time.

Generous acne assessment tools have been described, taking into account various elements such as the acne type, acne severity, number of acne lesions, anatomical location/ extent of acne, quality of life and other psychosocial measures, and acne scars, among other metrics. Recently, 18 of these grading scales were ranked based on a variety of variables. To date, there is no agreed entirely upon classification system, and systems can differ significantly between research. Also, the inter-observer reliability of these scales varies but has been poor in some research. Courses such as photographic standards have been used to correct reproducibility.

Advancements in digital technology, photographic tools, and teledermatology may grant for accurate, remote assessment of acne in the future medicine. The scientific standard such as Red fluorescence ultraviolet, level of casual sebum, imaging of skin capacitance, skin surface pH, and transepidermal water loss may also aid to more objectively categorize and rate acne in the future. Reproducibility, as well as simplify of use and approval by dermatologists, will be necessary for the success of any grading system. 

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