BACKGROUND: A good acne grading system should reflect epidemiological and clinical features of a particular patient group. Current Korean acne grading systems are mostly based on the skin colors, epidemiology, and clinical features of Western countries, which make them less than being ideal for Korean acne patients. OBJECTIVE: We tried to devise an acne grading system based on clinical and epidemiological characteristics of Korean acne patients. This system is intended for use in primary care setting as well as in research purposes. METHODS: In the formulation of a new acne grading system, a panel of 5 dermatologists from 5 referral centers took into account the degree of complexity of the system, criteria for severity as well as skin colors through the review of clinical photographs of 250 acne patients. The new grading system then underwent inter-rater and intra-rater discrepancy assessment and simulation with 149 patient photos to find out an optimal epidemiological representation. RESULTS: We developed 6-scale grading system with both standard pictures and ranges of number of lesions as criteria. Intra-rater and inter-rater reproducibility turned out to be moderate to strong, suggesting clear instruction and easy performance. Simulation with 4 different models yielded best parameter ranges for the optimal criteria. CONCLUSIONS: With the feedback from the large-scale field applications, this new acne grading system will serve as a multipurpose acne grading system for Korean patients.
Acne Vulgaris* ; Epidemiology ; Humans ; Primary Health Care ; Referral and Consultation ; Skin

By searching the database of CNKI, Wanfang and PubMed, the prevalence and risk factors of atopic dermatitis, psoriasis, acne, and urticaria were relatively more investigated, which were the skin diseases of more concern in the current epidemiological study of skin diseases. Three national epidemiologic surveys reported that the prevalence of atopic dermatitis increased from 0.69% in 1998, to 3.07% in 2002, and 12.94% in 2014, respectively. The prevalence of psoriasis increased from 0.123% in 1984 to 0.47% in 2009 according to 2 national surveys. The prevalence of acne was 8.1% in a national investigation in 2008. Representative national prevalence data of urticaria is not available. Risk factors for these skin diseases are distinct. Atopic dermatitis, psoriasis, and urticaria are more related to environment and mental stress, while acne is more related to skin type and dietary factors. Owing to the heterogeneities in diagnostic methods used in the dermatoepidemiologic surveys (some of the diagnoses were self-reported) and a lack of follow ups, the reliability of data remained questionable, and the comparability across the surveys was difficult. As a result, it is necessary to conduct population-based cohort studies on skin diseases in China.
Acne Vulgaris ; epidemiology ; China ; epidemiology ; Dermatitis, Atopic ; Humans ; Prevalence ; Psoriasis ; epidemiology ; Reproducibility of Results ; Risk Factors ; Urticaria

Objective To determine the relationship between air pollutants [SO
Acne Vulgaris ; Air Pollution/adverse effects* ; China/epidemiology* ; Environmental Pollutants ; Female ; Gases ; Humans ; Male ; Outpatients

OBJECTIVE: To understand the influential factors for depression in patients with facial acne vulgaris and to provide scientific evidence for a comprehensive and systematic treatment for acne vulgaris.
 METHODS: A total of 287 outpatients with facial acne vulgaris, who visited the dermatology of the Third Xiangya Hospital, were surveyed by Beck Depression Inventory (BDI). The data was collected by Epidata software (version 3.1) and processed by SPSS software package (version 18.0). The influential factors for the depression of outpatients with facial acne vulgaris were analyzed by multinomial logistic regression.
 RESULTS: A total of 181 patients with facial acne vulgaris showed various degrees of depression (BDI score≥5) and the rate was 63.1%. The symptoms for depression included sad and pessimistic attitude as well as the decreased attention to others (social withdrawal). The influential factors for mild, moderate or severe depression were gender, the degree and the course of acne. Female patients were more likely to suffer mild, moderate or severe depression (OR=3.62, 2.63, respectively); the risk of depression in acne patients was increased with the increase in degree of the severity (OR=2.31, 4.51, respectively); the patients with the acne course more than a year were more likely to show mild depression than those with a course less than a year (OR=4.30, 7.44, respectively). The patients with acne course more than 3 years were more likely to show moderate or severe depression compared to those with a course less than a year (OR=3.60).
 CONCLUSION Most of facial acne patients show a different degree of depression. The acne course is longer in female patients. The more severe the acne vulgaris is, the more suffering of the depression is. Psychological care should be considered to improve the treatment and quality of life.
Acne Vulgaris ; epidemiology ; Depression ; epidemiology ; Face ; pathology ; Female ; Humans ; Logistic Models ; Male ; Psychiatric Status Rating Scales ; Quality of Life ; Surveys and Questionnaires

OBJECTIVETo explore the correlation between syndrome types of late-onset acne female patients and constitutions of Chinese medicine (CM).

METHODSA questionnaire was performed in 365 late-onset acne female patients and 135 healthy subjects (as the control) using Professor WANG Qi's. methods and Standards for Chinese Medical Constitutions Classification.

RESULTSTheir CM constitutions were sequenced as damp-heat constitution, yin-deficiency constitution, balanced constitution, yang-deficiency constitution, blood-stasis constitution, qi-stagnation constitution, qi-deficiency constitution, phlegm-damp constitution, inherited special constitution, with statistical difference when compared with those of the control group ( χ2 = 85.206, P < 0.01). In the 365 female late-onset acne patients, 114 (31.23%) were with Chongren imbalance syndrome, 108 (29.59%) were with blood stasis or coagulated phlegm syndrome, 83 (22.74%) were with dampness heat syndrome, and 60 (16.44%) were with wind heat syndrome. There was statistical difference in CM constitution distributions among different CM syndrome types (χ2 = 105.671, P < 0.01). The distribution of CM medical constitutions was different between the two groups. Biased constitutions were often seen in the patient group, while balanced constitution was often seen in the control group. Binary Logistic regression analysis indicated that influencing factors covered sweet food, light diet, roasted food, coffee, stress, work pressure, and family pressure. Of them light diet was one protective factor, while the rest were adverse factors.

CONCLUSIONThe etiology and syndrome types of female late-onset acne female patients were associated with CM constitution.

Acne Vulgaris ; epidemiology ; Body Constitution ; Female ; Humans ; Medicine, Chinese Traditional ; Surveys and Questionnaires ; Syndrome ; Yang Deficiency ; Yin Deficiency

It was aimed to determine the normal hair scores of women of Kiri kkale region according to the Ferriman- Gallwey scale and to investigate the relationship between the hair shaft diameter and hair scores. Hair scores were calculated in 204 healthy women, and hair shaft diameters were measured from the hair samples collected from 60 patients. Body mass index, waist to hip ratio, insulin resistance and blood androgen levels were determined. Neutral, hormonal and total hair scores were 2.1+/-1.4, 3.1+/-2.7 and 5.2+/-3.6, respectively. The average total hair diameter and hormonal hair diameter were 191.93+/-90.49micrometer and 121.8+/-75.9micrometer respectively. The correlation between total hair diameter and total hair score was statistically significant (r=0.704 p< 0.001). Also, the correlation between hormonal hair diameter and hormonal hair score was statistically significant (r=0.724 p< 0.001). While hair scores and diameters show meaningful positive correlation with androgen levels, they show negative correlation with age. In our population, 95% value of total hair score was 11, and for the hormonal score, it was 9. Hair diameters increase with hair score, regardless of total or hormonal of hair scores. Hair scores and hair diameters may be affected by blood androgens in healthy women.
Acne Vulgaris/epidemiology ; Adult ; Female ; Hair/*anatomy & histology ; Hirsutism/*epidemiology/*pathology ; Human ; Incidence ; Middle Aged ; Prospective Studies ; Skin Pigmentation ; Turkey/epidemiology

Little is known about the treatment-seeking behaviors of acne patients, especially Asian acne patients. This study was performed to obtain detailed information about the treatment-seeking behaviors in Korean acne patients. Patients who visited the dermatology departments at 17 university hospitals completed a self-administered questionnaire. Most patients obtained information about acne from doctors or the Internet. The most important criteria for selecting a treatment method or choosing a particular clinic were effectiveness and accessibility. Patients used traditional medicine, visited beauty clinics, drank more water, and used over-the-counter topical agents more frequently than they sought doctors during the worsening period. The degree of satisfaction in treatment was found to depend on the total cost of treatment, number of places visited, site affected by acne, and emotional stress. Those who had experienced a side effect tended to have been treated for longer, to have paid more for treatment, and to have an associated skin disease. Treatments prescribed by dermatology clinics had the lowest aggravating rate, although improvement rates for family medicine clinics were also fairly high. This is the first study to investigate in detail the demographic features and characteristics of the treatmentseeking behaviors of acne patients in Asia.
Acne Vulgaris/epidemiology/*psychology/therapy ; Adult ; Demography ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Hospitals, University ; Humans ; Korea ; Male ; *Patient Satisfaction ; Questionnaires ; Sex Factors ; Stress, Psychological ; Young Adult

BACKGROUND: Acne is a common skin disorder which affects both adolescents and adults. However, there have been few Korean epidemiological studies conducted. OBJECTIVE: The purpose of this study was to analyze the prevalence, demographic factors, clinical features and aggravating factors of acne. We also investigated the relationship of these factors. METHODS: Epidemiological and clinical data was obtained by interviewing 657 acne patients, newly enrolled at Seoul National University Hospital Acne Clinic between 1996 and 2004. RESULTS: Most patients were found to have facial acne, and the forehead and cheeks were the most common sites where acne first developed. Males tended to visit the hospital because of social problems compared to females. We identified some significant correlations with sex, age of onset, disease duration, first affected site, seborrhea, and family history. Acne lesions developed earlier and disease duration was longer in the group with a family history of acne or severe seborrhea. More than 80% of patients were found to have subjective symptoms, including pain and itching which were most frequent. The degree of seborrhea was higher and the aggravation after sun exposure was more frequent in the group where complete remission of acne had not been achieved. Aggravation of acne was most frequent in summer, followed by winter. CONCLUSION: We could investigate the epidemiological and clinical features of acne patients, including the age of onset, motive of treatment, subjective symptoms, plus outcome of treatment according to remission history of acne, as these factors have never been reported in the Korean literature before.
Acne Vulgaris* ; Adolescent ; Adult ; Age of Onset ; Cheek ; Demography ; Dermatitis, Seborrheic ; Epidemiologic Studies ; Epidemiology ; Female ; Forehead ; Humans ; Male ; Prevalence ; Pruritus ; Seoul* ; Skin ; Social Problems ; Solar System

This study was conducted to clarify the prevalence of common skin diseases and their associated factors among military personnel in Korea. Four dermatologists visited adjacent military units and examined soldiers. A structured questionnaire that included questions about known skin diseases, demographic information, and questions for the Perceived Stress Index was completed for each participant. The soldiers that had been diagnosed with a skin disease answered one additional questionnaire (Skindex-29) which assess the influence of an individual's skin disease on daily life. Of 1,321 soldiers examined, 798 (60.4%) had one or more skin diseases. The three most common skin problems were acne (35.6%), tinea pedis (15.2%) and atopic dermatitis (5.1%). The diseases closely related to the period of military service were acne, tinea pedis, viral warts and corns. The diseases related to the amount of stress were atopic dermatitis, seborrheic dermatitis, and acne. The most troublesome skin diseases were atopic dermatitis, tinea cruris, and seborrheic dermatitis. These results demonstrated that the prevalence of skin disease among military personnel in Korea is very high, and that some of the skin disorders may have a significant influence on their daily lives.
Acne Vulgaris/epidemiology ; Adult ; Cross-Sectional Studies ; Dermatitis, Atopic/epidemiology ; Humans ; Male ; Military Personnel ; Odds Ratio ; Prevalence ; Quality of Life ; Questionnaires ; Republic of Korea/epidemiology ; Risk Factors ; Skin Diseases/diagnosis/*epidemiology ; Stress, Psychological ; Tinea Pedis/epidemiology ; Young Adult

BACKGROUND: There has been no statistical study of dermatoses in the Suwon area and southern area of Kyonggi province which has been rapidly developing in the last 7 years. OBJECTIVE AND METHODS: We evaluated the recent distributions of dermatoses in the Suwon area and southern area of Kyonggi and compared them with the previous reports of other provinces of Korea. Fifty two thousand, one hundred fifty three new outpatients who visited the Ajou University Hospital from 1995 to 2001 were analysed statistically. RESULTS: The study results are summarized as follows: Among the 52, 153 outpatients, the total number of male patients were 24, 005(46.0%) and female patients were 28, 148(54.0%). The frequency of age groups are as follows; the age groups were the 3rd decade(22.0%), 4th decade(20.4%), 1st decade(18.7%), 5th decade(11.5%), 2nd decade(11.1%), 6th(8.5%), 7th(5.4%), 8th and above(2.4%). The distributions of dermatoses as disease groups were eczema(28.6%), dermatophytosis(8.7%), erythema urticaria and drug eruption(8.1%), disease of skin appendages(7.9%), viral infection(7.3%), etc. Those dermatoses which demonstrated a tendency to increase annually were seborrheic dermatitis, hyperpigmentary disorders, verruca, and alopecia areata. The incidence of dermatophytosis, in particular, decreased during the study period. Seasonal distribution showed that those diseases occurring the most frequently during the summer were dermatophytosis, allergic contact dermatitis, urticaria, verruca, and vitiligo. The incidence of atopic dermatitis and nevocellular nevi increased during the winter season. Acne vulgaris was the disease occurring frequently during summer and winter. Sexual distribution of dermatoses showed that hyperpigmentary disorder, nevocellular nevi, benign epidermal tumor, acne, allergic contact dermatitis, and irritant contact dermatitis were more frequent in females, and dermatophytosis, seborrheic dermatitis, alopecia were more frequent in males. Age distribution was as follows; atopic dermatitis, vitiligo and verruca was the most frequent in the 1st decade. Acne vulgaria was the most frequent in the 2nd decade and 3rd decade. Hyperpigmentary disorder and seborrheic dermatitis were the most frequent in the 4th decade. Hyperpigmentary disorder was the most frequent in the 5th decade and herpes zoster in 6th, 7th and 8th decade and above. CONCLUSION: In contrast to an earlier published report from Seoul, the infectious dermatoses, especially parasitic infestation, showed a tendency to decrease and nevocellular nevi, hyperpigmentary disorder and alopecia showed a tendency to increase. The distribution pattern of the skin disease did not differ from other provinces of Korea in general.
Acne Vulgaris ; Age Distribution ; Alopecia ; Alopecia Areata ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Epidemiology ; Erythema ; Female ; Gyeonggi-do* ; Herpes Zoster ; Humans ; Incidence ; Korea ; Male ; Nevus ; Outpatients ; Seasons ; Seoul ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Vitiligo ; Warts