寻常痤疮对患者心理的影响

目的：了解痤疮患者心理受影响的程度和一些相关因素。方法：对北京、上海、广州、西安、武汉5个城市共2331例门诊痤疮患者采用APSEA量表进行问卷式调查。结果：痤疮影响了部分患者的心理健康，表现为焦虑、易怒和不自信。甚至干扰了他们的生活、影响择业。参与影响痤疮患者生活质量的可能因素是痤疮的严重程度、患者的文化程度。结论：痤疮对于患者的心理具有一定程度的影响，应该引起皮肤科医生的重视，尤其是重度痤疮和文化程度低的患者。     

The impact of acne on quality of life

Optimal acne therapy must take into account not only acne type and severity, but also the impact of this skin disorder on the patients quality of life. Several validated instruments have been used to measure quality of life in acne patients. By using these instruments, acne patients have been shown to experience levels of social, psychological and emotional distress similar to those reported in patients with asthma, epilepsy and diabetes. Several studies have demonstrated that the disability caused by acne can be mitigated by effective therapy.     

饮食与生活习惯对痤疮发病的影响

目的：确定痤疮发病的危险因素,为干预痤疮的发生和发展提供依据。方法：我科对门诊300例痤疮患者进行了饮食及生活习惯问卷调查,用SPSS17.0软件分析与痤疮发病的危险因素。结果：多因素logistic回归分析,病例组的睡眠不规律比例比对照组高,差异具有统计学意义(P <0.05), 其OR值为1.979>1;病例组食用辛辣食品、甜食等饮食因素的比例较对照组高,但差异无统计学意义(P＞0.05)。结论：未发现饮食因素对痤疮的发病有影响,睡眠不规律可能是痤疮发病的独立危险因素。     

DLQI测量寻常型痤疮及白癜风患者生活质量的研究

目的比较寻常型痤疮患者与白癜风患者的生活质量。方法采用中文版皮肤病生活质量指标（delmatolo-gylifequalityindex,DLQI）对门诊寻常型痤疮患者与白癜风患者进行调查,并检测量表的信度和效度。结果寻常型痤疮患者DLQI得分为8．68,白癜风组得分为6．34．除条目1、条目3以及条目7,痤疮组得分高于白癜风组外,其余7个方面两组得分均无差别。DLQI量表测量痤疮与白癜风均具有较好的信度和效度,但条目1不能在白癜风患者间形成有效地区分度一结论寻常型痤疮患者的生活质量低于白癜风患者。DLQI量表用于测量白癜风患者的生活质量时应进行修订。     

Effects of skin care and makeup under instructions from dermatologists on the quality of life of female patients with acne vulgaris

Acne vulgaris significantly affects patients' quality of life (QOL) and their lives in various ways, including social behavior and body dissatisfaction. This may be heightened by acne's typical involvement of the face. We investigated whether the use of skin care and makeup could influence the QOL of affected patients without deteriorating conventional acne treatments. Fifty female patients with acne were recruited for our study. Twenty-five patients were instructed how to use skin care and cosmetics, while 25 patients received no specific instructions from dermatologists. Both groups received conventional topical and/or oral medication for acne during the study period for 4 weeks. Both groups did not show any significant difference in clinical improvement of acne severity. Two validated QOL questionnaires, World Health Organization (WHO)QOL26 and the Dermatology Life Quality Index (DLQI) were administered to all patients at first visit and 4 weeks later. The mean scores of psychological and overall domains in WHOQOL26 for patients with instructions were improved significantly, while only the overall score was significantly improved for patients without instructions. The total mean scores and all domains except work/school in DLQI for patients with instructions were improved significantly, while the total scores and all domains except discomfort for treatment in DLQI were significantly improved for patients without instructions. Thus, instructions on the use of skin care and cosmetics for female acne patients did not deteriorate acne treatment and influenced patients' QOL effectively. We therefore suggest that instructions for using skin care and cosmetics complement conventional medical treatments for acne.     

High-dose isotretinoin in acne vulgaris: improved treatment outcomes and quality of life

Background Isotretinoin, for acne treatment, is associated with high rates of permanent remission. However, at recommended doses of 0.5-1.0 mg/kg/day for 5-6 months [average cumulative dose: 120-150 mg/kg], more than 20% of patients experience a relapse within two years that requires further medical management. Objective To examine outcomes of high-dose isotretinoin in a cohort with cystic acne, as well as measuring its impact on quality of life (QOL). Methods A single dermatologist, single institution investigation within an academic tertiary care center in Bronx, NY. Eighty patients with nodulocystic acne, maintained on oral isotretinoin at a dose of 1.3 mg/kg/day or greater, were studied from 2006-2009 while additionally participating in a QOL survey. Main outcome measures included documented events, acne clearance, presence of relapse, and quality of life parameters. Results The mean daily dose of isotretinoin was 1.6 mg/kg/day for an average time course of 178 days [cumulative dose: 290 mg/kg]. No side effects or laboratory abnormalities led to discontinuation of treatment. There were no psychiatric symptoms. One-hundred percent (100%) of patients were disease-free upon completion of treatment. During the three-year study period, 10 patients (12.5%) developed a relapse that required an additional course of isotretinoin. Analysis of QOL domains (self-perception, role-social, symptoms) revealed significant improvement following isotretinoin therapy (p = 0.0124, p = 0.0066, p = 0.0265, respectively). Conclusions Isotretinoin prescribed at 1.5 mg/kg/day or greater for 5-6 months [cumulative total dose of 290 mg/kg] is safe and effective compared to current standard dosing practices. We propose the use of high-dose isotretinoin (>1.3 mg/kg/day) as a treatment option in severe nodulocystic acne and encourage larger, prospective, multicenter studies into this therapeutic approach.     

Effects of isotretinoin on social anxiety and quality of life in patients with acne vulgaris: a prospective trial

Social anxiety is common in acne patients and the effects of isotretinoin treatment on social anxiety symptoms have not yet been thoroughly investigated. The aim of the study was to assess the effects of isotretinoin treatment on the quality of life and social anxiety symptoms in a group of acne vulgaris patients. The Liebowitz Social Anxiety Scale (LSAS) and Short Form-36 (SF-36) were administered to 39 (24 female and 15 male) patients with acne vulgaris who accepted isotretinoin treatment and agreed to participate in the study. The severity of acne was evaluated using the Global Acne Grading System. Thirty patients completed 6-month treatment with oral isotretinoin at 0.5-1.0 mg/kg daily doses. Measurements were repeated at the end of 6 months. Acne significantly improved over time in the study group. The mean performance avoidance score in LSAS and mean pain and social functioning scores in SF-36 were significantly better at the end of isotretinoin treatment. In conclusion, isotretinoin treatment improves the quality of life and social anxiety symptoms in acne patients.     

The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece. Results of a population survey

BACKGROUND

Acne vulgaris can severely affect social and psychological functioning.

OBJECTIVE

The aim of this study was to investigate the impact of acne vulgaris and its severity on Quality of Life of young adolescents in Greece.

METHODS

We conducted a questionnaire based survey among 1560 adolescent between the ages of 11 and 19 years old and 1531 of these were completed. Adolescents with acne filled all the questions including the Children Dermatology Life Quality Index. Adolescents without acne filled the questions about age, family history of acne, stress and smoking. Data were analyzed with Pearson Chi Square test.

RESULTS

Acne prevalence was 51.2% affecting both sexes equally. Self reported mild acne was present in 71.2% and moderate-severe acne in 28.8% of the study population. The mean age of the study population was 15.77y. The median score of Children Dermatology Life Quality Index was 4.02. The impact of acne on quality of life is associated with the severity of the acne (p<0.0001). Patients with moderate/severe acne experience greater psychosocial and emotional impairment (p<0.0001). Body image is modified proportionally to the severity of acne (p<0.0001). Symptoms and treatment of acne are factors that also influence their quality of life. Girls and boys are equally affected. Stress and heredity are correlated with acne and its severity (p<0.0001). We didn''t find any correlation between smoking and acne.

CONCLUSION

Acne affects Quality of Life of young adolescents in Greece. The impact is proportional to the severity of acne. More severe acne is associated with greater effect on quality of life with implications for self esteem, body image and relationships with others.     

Incidence of acne vulgaris in patients with infantile acne

A group of patients who attended dermatology clinics in Northern Ireland between 1960 and 1970 with a diagnosis of infantile acne was compared with a similar age-matched control group of 160 medical students. The severity of the acne was judged according to the form of treatment required--topical treatment, systemic antibiotics or isotretinoin. The statistical power of this study is limited but there appears to be a trend towards higher incidence and greater severity of acne vulgaris in teenage years in patients with a history of infantile acne compared to their peers.     

痤疮及相关因素对患者生活质量的影响

新的医学模式提倡临床医生在治疗寻常痤疮患者时,不仅要考虑痤疮分型及临床严重程度,还要考虑患者生活质量受到的影响.近年来,应用不同量表为工具的调查研究均表明,痤疮对患者生活质量有较大的影响,但其对不同年龄、性别患者的影响评价不一.提示专科医生有必要对患者生活质量所受到的影响进行个体化评估,进而选择最佳的治疗方案.     

Effects of oral antibiotic roxithromycin on quality of life in acne patients

Macrolides are effective for inflammatory acne, but there are not many studies on roxithromycin. In this study, patients with acne were surveyed for improvement of their quality of life after treatment with roxithromycin. Patients were orally given roxithromycin 300 mg daily for 2–4 weeks. At the time of pre- and post-treatment, the dermatologists graded the severity of acne symptoms, and the patients answered questionnaires. In 123 half faces of 76 patients, 80 half faces were improved, 42 half faces were not changed, and one half face was deteriorated. The score of symptom and feeling and leisure in DLQI-J and emotions and symptoms in Skindex-29-J were significantly decreased after roxithromycin treatment. Roxithromycin has a therapeutic effect on inflammatory acne and leads to improvement of quality of life in the patients.     

Psychosocial impact of acne vulgaris: evaluating the evidence

This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Study methodologies, including case-control and cross-sectional surveys, have demonstrated psychological abnormalities including depression, suicidal ideation, anxiety, psychosomatic symptoms, including pain and discomfort, embarrassment and social inhibition. Effective treatment of acne was accompanied by improvement in self-esteem, affect, obsessive-compulsiveness, shame, embarrassment, body image, social assertiveness and self-confidence. Acne is associated with a greater psychological burden than a variety of other disparate chronic disorders. Future studies with a longitudinal cohort design may provide further validation of the causal inference between acne and psychosocial disability provided by the current literature.     

对痤疮患者生活质量影响因素的分析

目的:了解痤疮患者生活质量及其影响因素。方法:采用自制生活质量调查问卷,对345例痤疮患者进行调查。结果:痤疮患者生活质量降低。多因素Logistic回归分析表明:自我感知和情感功能同性别、家庭情况、痤疮轻重分级和学生与否相关性密切;社会功能同长期居住地、痤疮轻重分级和学生与否相关性密切。结论:针对上述影响因素,临床医师适当实施心理干预措施和健康教育,有助于提高痤疮患者的生活质量。