Quality of life in mild to moderate acne: relationship to clinical severity and factors influencing change with treatment.
BACKGROUND
Because of its effects on quality of life, acne vulgaris is more than a merely physiological or cosmetic entity.


OBJECTIVE
To describe the influence of mild to moderate acne on patients' quality of life, measured using Skindex-29, and to correlate changes in Skindex-29 scores with changes in objective and subjective indices in clinical severity after treatment with topical 4% erythromycin 0.2% zinc. Also, to evaluate efficacy and side-effects of the treatment.


METHODS
Observational, prospective study of 1878 patients cared for by 252 clinicians in Spain. Data included epidemiological information and responses to Skindex-29, a subjective change and objective severity index.


RESULTS
Baseline Skindex scale scores were worse in women, older patients, and those with more severe clinical disease. Skindex was sensitive to changes in objective severity but changes in Skindex scale scores were also related to other factors. Patients who reported their skin condition to be 'the same' or 'worse' at the end of the study had significantly worse baseline scores on the 'symptoms' and 'emotions' scales but 'functioning' scores were not worse than for those who reported their condition had improved.


CONCLUSIONS
The effects of acne vulgaris on quality of life and changes in quality of life after treatment are not only explainable by objective severity of acne. Patients' and clinicians' judgements about acne severity are different.
Jones-Caballero
M
M
Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.
Chren
M M
MM
Soler
B
B
Pedrosa
E
E
Peñas
P F
PF
D000152:Acne Vulgaris / Q000188:drug therapy / Q000523:psychology*; D000287:Administration, Topical; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D015032:Zinc / Q000627:therapeutic use
D004917:Erythromycin; D015032:Zinc