Review of Answer Choices (Correct Answer in Green):
A. Mild acne with primarily inflammatory lesions
B. Moderate acne with primarily inflammatory papules
C. Moderate acne with several nodulocystic lesions
D. Severe acne with primarily inflammatory papules
Explanation:
A. Mild acne with primarily inflammatory lesions: This is not the most correct option as mild acne would primarily consist of comedones with no nodulocystic lesions.
B. Moderate acne with primarily inflammatory papules: Rebecca’s acne is primarily papular and there is no truncal involvement or scarring.
C. Moderate acne with several nodulocystic lesions: This is not the correct option as Rebecca’s acne is primarily papular rather than nodulocystic.
D. Severe acne with primarily inflammatory papules: This is not the correct option as Rebecca’s predominantly papular acne, lack of truncal involvement and scarring do not suggest a severe acne presentation.
When deciding the severity of acne, there are many factors one needs to consider. There is no one universal system for severity grading. One example is the IAA grading of acne severity:
- Mild acne: Predominance of comedones, with < 10 papules and no scarring
- Moderate acne: Predominance of papules, with > 10 papules, with or without scarring
- Severe acne: Many nodulocystic lesions with scarring
To facilitate therapeutic decisions, you should use a consistent method of grading and classifying acne based on:
- Number of acne lesions (descriptive such as few vs many, or quantitative with ranges): be cautious about differentiating active lesions and pigment changes from healed lesions
- Clinical type of acne: there are comedonal, papulopustular, mixed, and nodular types
- Disease severity: mild, moderate, or severe
- Anatomical sitesScarring: post-inflammatory erythema or indented scars
- Impact on quality of life: dermatology life quality index (DLQI) is a 10-question survey you can use to quantitatively measure the impact