Inter-observer agreement on acne severity based on facial photographs.
BACKGROUND
The three-grade acne classification (mild, moderate, severe) is widely used to define the licensed indications of acne treatments, and for therapeutic decision-making in clinical practice, but its reproducibility has never been assessed.


METHODS
Ten photographs of facial acne were scored independently by eight experts using the three-grade acne classification. We conducted a descriptive analysis of the results, based on graphical representation of the scores for each photograph.


RESULTS
Inter-observer agreement on acne severity based on the three-grade acne classification was very poor.


CONCLUSIONS
The classical three-grade acne classification is poorly reproducible. A new rating tool accompanied by a clinical description of each severity level would be extremely useful.
Beylot
C
C
Clinique de Dermatologie, Hôpital Edouard Herriot, Lyon Cedex, France.
Chivot
M
M
Faure
M
M
Pawin
H
H
Poli
F
F
Revuz
J
J
Auffret
N
N
Moyse
D
D
Dréno
B
B
D000152:Acne Vulgaris / Q000473:pathology* / Q000628:therapy; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index