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萎缩性痤疮瘢痕风险评估工具的开发。

Development of an atrophic acne scar risk assessment tool.

机构信息

Western University, Windsor Campus, Windsor, ON, Canada.

Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, PA, USA.

出版信息

J Eur Acad Dermatol Venereol. 2017 Sep;31(9):1547-1554. doi: 10.1111/jdv.14325. Epub 2017 Jul 3.

Abstract

BACKGROUND

Acne is a chronic dermatological disease predominantly afflicting young adults and is often associated with the development of scars. Acne scarring is usually avoidable when acne is managed early and effectively. However, acne patients often fail to seek early treatment. New and innovative tools to raise awareness are needed.

OBJECTIVE

This study presents the development and assessment of a tool aiming to assess the risk of atrophic acne scars.

METHODS

A systematic literature review of clinical risk factors for acne scars, a Delphi-like survey of dermatological experts in acne and secondary data analysis, were conducted to produce an evidence-based risk assessment tool. The tool was assessed both with a sample of young adults with and without scars and was assessed via a database cross-validation.

RESULTS

A self-administered tool for risk assessment of developing atrophic acne scars in young adults was developed. It is a readily comprehensible and practical tool for population education and for use in medical practices. It comprises of four risk factors: worst ever severity of acne, duration of acne, family history of atrophic acne scars and lesion manipulation behaviours. It provides a dichotomous outcome: lower vs. higher risk of developing scars, thereby categorizing nearly two-thirds of the population correctly, with sensitivity of 82% and specificity of 43%.

CONCLUSION

The present tool was developed as a response to current challenges in acne scar prevention. A potential benefit is to encourage those at risk to self-identify and to seek active intervention of their acne. In clinical practice, we expect this tool may help clinicians identify patients at risk of atrophic acne scarring and underscore their requirement for rapid and effective acne treatment.

摘要

背景

痤疮是一种主要影响年轻人的慢性皮肤病,常伴有疤痕的形成。若能及早、有效地治疗痤疮,通常可以避免痤疮疤痕的产生。然而,痤疮患者往往未能及时就医。因此,我们需要新的创新工具来提高人们的认识。

目的

本研究旨在开发和评估一种用于评估萎缩性痤疮疤痕风险的工具。

方法

对痤疮疤痕的临床危险因素进行系统文献回顾,对痤疮领域的皮肤科专家进行德尔菲式调查,并对二级数据进行分析,从而制定出基于证据的风险评估工具。该工具在有和无疤痕的年轻成年人样本中进行了评估,并通过数据库交叉验证进行了评估。

结果

开发了一种用于评估年轻成年人发生萎缩性痤疮疤痕风险的自我管理工具。它是一种易于理解和实用的人群教育工具,也可用于医疗实践。它由四个危险因素组成:痤疮最严重的严重程度、痤疮持续时间、家族史萎缩性痤疮疤痕和病变操作行为。它提供了一个二分结果:低风险与高风险发生疤痕,从而正确分类近三分之二的人群,其敏感性为 82%,特异性为 43%。

结论

本工具是为应对痤疮疤痕预防的当前挑战而开发的。一个潜在的好处是鼓励那些有风险的人自我识别,并寻求对他们的痤疮进行积极干预。在临床实践中,我们期望该工具可以帮助临床医生识别有发生萎缩性痤疮疤痕风险的患者,并强调他们需要快速有效的痤疮治疗。

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