J Cutan Med Surg. 2014 Jul-Aug;18(4):243-55. doi: 10.2310/7750.2013.13154.
Most treatment guidelines for acne are based on clinical severity. Our objective was to expand that approach to one that also comprised individualized patient features: a case-based approach.
An expert panel of Canadian dermatologists was established to develop demographic and clinical features considered to be particularly important in acne treatment selection. A nominal group consensus process was used for inclusion of features and corresponding appropriate treatments.
Consensus was achieved on the following statements: follicular epithelial dysfunction contributes to acne pathogenesis; inflammation from underlying disease(s) or prior treatment may impact further patient management; management focusing on specific patient features and on addressing psychosocial factors, including impact on quality of life, may improve treatment adherence and outcomes; and case-based scenarios are a practical approach to illustrate the effect of these factors. To address the latter, eight case profiles were developed.
Management of acne should be based on multifactorial considerations beyond clinically determined acne severity and should include patient-reported impact, gender, skin sensitivity (including preexisting dermatoses), and phototype.
大多数痤疮治疗指南都是基于临床严重程度制定的。我们的目标是将这种方法扩展到一种还包括个体化患者特征的方法：基于病例的方法。
成立了一个加拿大皮肤科医生专家组，以确定在痤疮治疗选择中被认为特别重要的人口统计学和临床特征。采用名义小组共识过程来确定特征和相应的适当治疗方法。
就以下陈述达成共识：滤泡上皮功能障碍导致痤疮发病机制；潜在疾病或先前治疗引起的炎症可能会影响进一步的患者管理；专注于特定患者特征和解决心理社会因素（包括对生活质量的影响）的管理可能会提高治疗依从性和结果；基于病例的情景是说明这些因素影响的实用方法。为了解决后者，开发了八个病例简介。
痤疮的治疗应基于临床确定的严重程度以外的多因素考虑因素，并且应包括患者报告的影响、性别、皮肤敏感性（包括现有皮肤病）和光型。
