title: Inter-observer agreement on acne severity based on facial photographs.
abstract: 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.
authors.affiliation: Clinique de Dermatologie, Hôpital Edouard Herriot, Lyon Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Beylot
authors.forename: M
authors.initials: M
authors.lastname: Chivot
authors.forename: M
authors.initials: M
authors.lastname: Faure
authors.forename: H
authors.initials: H
authors.lastname: Pawin
authors.forename: F
authors.initials: F
authors.lastname: Poli
authors.forename: J
authors.initials: J
authors.lastname: Revuz
authors.forename: N
authors.initials: N
authors.lastname: Auffret
authors.forename: D
authors.initials: D
authors.lastname: Moyse
authors.forename: B
authors.initials: B
authors.lastname: Dréno
mesh_terms: 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