[开放获取]    寻常痤疮临床严重度分级及疗效评价中国专家共识

doi:10.35541/cjd.20250034

Abstract

Abstract: 【Abstract】 Acne vulgaris （abbreviated as acne） is a common aesthetic?impairing dermatological disease that markedly affects appearance, and is characterized by diverse clinical manifestations. At present, there are various grading systems for acne severity, while there is still a lack of unified standards for objectively assessing disease severity to guide treatment selection and scientifically evaluating the efficacy of acne therapies, which are highly concerning issues for clinicians. To address this, the Acne Study Group of China Dermatologist Association, the Dermatology Professional Committee of Chinese Research Hospital Association, and the Acne Study Group of Dermatology and Venereology Professional Committee of Chinese Association of Integrative Medicine organized a group of experts in the field of acne diagnosis and treatment in China to develop the "Chinese expert consensus on clinical severity grading and therapeutic evaluation of acne vulgaris" after extensive discussions, aiming to provide a reference for dermatologists in clinical practice.

Key words: Acne vulgaris, Treatment, Clinical severity grading, Therapeutic evaluation, Expert consensus

Acne Study Group of China Dermatologist Association, Dermatology Professional Committee of Chinese Research Hospital Association, Acne Study Group of Dermatology and Venereology Professional Committee of Chinese Association of Integrative Medicine. Chinese expert consensus on clinical severity grading and therapeutic evaluation of acne vulgaris[J]. Chinese Journal of Dermatology,2025,e20250034. doi:10.35541/cjd.20250034

References ［53］

［1］	Shen Y, Wang T, Zhou C, et al. Prevalence of acne vulgaris in Chinese adolescents and adults: a community⁃based study of 17,345 subjects in six cities［J］. Acta Derm Venereol, 2012,92（1）:40⁃44. doi: 10.2340/00015555⁃1164.
［2］	鞠强. 中国痤疮治疗指南（2019修订版）［J］. 临床皮肤科杂志, 2019,48（9）:583⁃588. doi: 10.16761/j.cnki.1000⁃4963.2019. 09.020.
［3］	Lehmann HP, Robinson KA, Andrews JS, et al. Acne therapy: a methodologic review［J］. J Am Acad Dermatol, 2002,47（2）:231⁃240. doi: 10.1067/mjd.2002.120912.
［4］	Tan J, Wolfe B, Weiss J, et al. Acne severity grading: determining essential clinical components and features using a Delphi consensus［J］. J Am Acad Dermatol, 2012,67（2）:187⁃193. doi: 10.1016/j.jaad.2011.09.005.
［5］	Barratt H, Hamilton F, Car J, et al. Outcome measures in acne vulgaris: systematic review［J］. Br J Dermatol, 2009,160（1）:132⁃136. doi: 10.1111/j.1365⁃2133.2008.08819.x.
［6］	Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations［J］. BMJ, 2008,336（7650）:924⁃926. doi: 10. 1136/bmj.39489.470347.AD.
［7］	Crocker TF, Lam N, Jordão M, et al. Risk⁃of⁃bias assessment using Cochrane's revised tool for randomized trials （RoB 2） was useful but challenging and resource⁃intensive: observations from a systematic review［J］. J Clin Epidemiol, 2023,161:39⁃45. doi: 10.1016/j.jclinepi.2023.06.015.
［8］	Martimbianco A, Sá K, Santos GM, et al. Most Cochrane systematic reviews and protocols did not adhere to the Cochrane's risk of bias 2.0 tool［J］. Rev Assoc Med Bras （1992）, 2023,69（3）:469⁃472. doi: 10.1590/1806⁃9282.2022 1593.
［9］	Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system［J］. Int J Dermatol, 1997,36（6）:416⁃418. doi: 10.1046/j.1365⁃4362.1997. 00099.x.
［10］	Dréno B, Poli F, Pawin H, et al. Development and evaluation of a Global Acne Severity Scale （GEA Scale） suitable for France and Europe［J］. J Eur Acad Dermatol Venereol, 2011,25（1）:43⁃48. doi: 10.1111/j.1468⁃3083.2010.03685.x.
［11］	Pillsbury D, Shelley W, Kligman A. Dermatology［M］. Philadelphia, PA: W.B. Saunders, 1956.
［12］	Burke BM, Cunliffe WJ. The assessment of acne vulgaris⁃⁃the Leeds technique［J］. Br J Dermatol, 1984,111（1）:83⁃92. doi: 10.1111/j.1365⁃2133.1984.tb04020.x.
［13］	刘根起, 陈树民. 痤疮综合分级系统和皮损计数法的一致性评价［J］. 中华皮肤科杂志, 2004, 37（7）: 403⁃405.
［14］	Yu R, Chen M, Zhao H, et al. Comparisons of four acne grading systems recommended in China, Korea, and Japan［J］. Clin Cosmet Investig Dermatol, 2023,16:203⁃210. doi: 10.2147/CCID.S400226.
［15］	Yu R, Fei W, Ning X, et al. Inter⁃rater variability and consistency within four acne grading systems recommended in China, USA, and Europe［J］. J Cosmet Dermatol, 2022,21（11）:6156⁃6162. doi: 10.1111/jocd.15178.
［16］	Lucky AW, Barber BL, Girman CJ, et al. A multirater validation study to assess the reliability of acne lesion counting［J］. J Am Acad Dermatol, 1996,35（4）:559⁃565. doi: 10.1016/s0190⁃9622（96）90680⁃5.
［17］	Thiboutot D, Gollnick H, Bettoli V, et al. New insights into the management of acne: an update from the global alliance to improve outcomes in acne group［J］. J Am Acad Dermatol, 2009,60（5 Suppl）:S1⁃50. doi: 10.1016/j.jaad.2009.01.019.
［18］	Center for Drug Evaluation and Research. Acne vulgaris: establishing effectiveness of drugs intended for treatment guidance for industry ［Z/OL］. （2018⁃05⁃01）［2025⁃01⁃14］. https://www.fda.gov/media/71152/download.
［19］	赵辨. 中国临床皮肤病学［M］. 南京: 江苏科学技术出版社, 2010.
［20］	Newman MD, Bowe WP, Heughebaert C, et al. Therapeutic considerations for severe nodular acne［J］. Am J Clin Dermatol, 2011,12（1）:7⁃14. doi: 10.2165/11532280⁃000000000⁃00000.
［21］	Nast A, Dréno B, Bettoli V, et al. European evidence⁃based （S3） guidelines for the treatment of acne［J］. J Eur Acad Dermatol Venereol, 2012,26（Suppl 1）:1⁃29. doi: 10.1111/j.1468⁃3083.2011.04374.x.
［22］	Patel DP, Bernardis E, Yan AC. The patient⁃centered acne severity scale study［J］. Pediatr Dermatol, 2017,34（6）:656⁃660. doi: 10.1111/pde.13262.
［23］	Desai K, Frey MP, Tan J. The utility of assessing neck acne［J］. J Cutan Med Surg, 2017,21（1）:82⁃83. doi: 10.1177/12034 75416673051.
［24］	Auffret N, Claudel JP, Leccia MT, et al. AFAST ⁃ Adult Female Acne Scoring Tool: an easy⁃to⁃use tool for scoring acne in adult females［J］. J Eur Acad Dermatol Venereol, 2016,30（5）:824⁃828. doi: 10.1111/jdv.13518.
［25］	Lim ZV, Akram F, Ngo CP, et al. Automated grading of acne vulgaris by deep learning with convolutional neural networks［J］. Skin Res Technol, 2020,26（2）:187⁃192. doi: 10.1111/srt.12794.
［26］	National Institute for Health and Care Excellence. Acne vulgaris: management （NG.198）（2023）［EB/OL］. （2023⁃12⁃07）［ 2025⁃01⁃14］. https://www.nice.org.uk/guidance/ng198.
［27］	Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris［J］. J Am Acad Dermatol, 2024,90（5）:1006.e1⁃1006.e30. doi: 10.1016/j.jaad.2023.12.017.
［28］	U.S. Food and Drug Administration. Guidance for industry acne vulgaris: developing drugs for treatment［EB/OL］. （2005⁃09⁃20）［2025⁃01⁃14］. https://www.regulations.gov/document/FDA⁃2005⁃D⁃0461⁃0002.
［29］	Eichenfield LF, Wortzman M. A novel gel formulation of 0.25% tretinoin and 1.2% clindamycin phosphate: efficacy in acne vulgaris patients aged 12 to 18 years［J］. Pediatr Dermatol, 2009,26（3）:257⁃261. doi: 10.1111/j.1525⁃1470.2008.00862.x.
［30］	刁庆春, 薛梅, 万远方. 0.1%他扎罗汀乳膏短时接触治疗寻常痤疮的疗效观察［J］. 中华皮肤科杂志, 2010,43（2）:116⁃117. doi:10.3760/cma.j.issn.0412⁃4030.2010.02.019.
［31］	刘伦飞, 严建良, 方红, 等. 异维A酸红霉素凝胶治疗寻常痤疮的多中心随机对照临床研究［J］. 中华皮肤科杂志, 2010,43（12）:867⁃870.
［32］	黄玉成, 李红文, 李雪莉, 等. 果酸换肤联合强脉冲光治疗痤疮的临床观察［J］. 中华皮肤科杂志,2013,46（7）:515⁃516. doi:10.3760/cma.j.issn.0412⁃4030.2013.07.021.
［33］	Lueangarun S, Sriviriyakul K, Tempark T, et al. Clinical efficacy of 0.5% topical mangosteen extract in nanoparticle loaded gel in treatment of mild⁃to⁃moderate acne vulgaris: a 12⁃week, split⁃face, double⁃blinded, randomized, controlled trial［J］. J Cosmet Dermatol, 2019,18（5）:1395⁃1403. doi: 10.1111/jocd.12856.
［34］	Fazelzadeh Haghighi N, Dastgheib L, Saki N, et al. Montelukast as an effective adjuvant in the treatment of moderate acne vulgaris［J］. Dermatol Ther, 2022,35（10）:e15770. doi: 10.1111/dth.15770.
［35］	Zane C, Capezzera R, Pedretti A, et al. Non⁃invasive diagnostic evaluation of phototherapeutic effects of red light phototherapy of acne vulgaris［J］. Photodermatol Photoimmunol Photomed, 2008,24（5）:244⁃248. doi: 10.1111/j.1600⁃0781.2008.00368.x.
［36］	Sadati MS, Yazdanpanah N, Shahriarirad R, et al. Efficacy of metformin vs. doxycycline in treating acne vulgaris: an assessor⁃blinded, add⁃on, randomized, controlled clinical trial［J］. J Cosmet Dermatol, 2023,22（10）:2816⁃2823. doi: 10.1111/jocd. 15785.
［37］	吴盘红, 王丽, 李庆娟, 等. 毫火针治疗Ⅳ级重度痤疮后瘢痕的临床效果评价［J］. 中华整形外科杂志, 2020,36（12）:1324⁃1330. doi: 10.3760/cma.j.cn114453⁃20200414⁃00220.
［38］	夏栩琼, 徐慧, 陆雯丽, 等. 30%超分子水杨酸治疗寻常痤疮的疗效观察［J］. 中国皮肤性病学杂志, 2019,33（5）:616⁃619. doi:10.13735/j.cjdv.1001⁃7089.201805076.
［39］	刘源, 莫衍石, 张雅洁, 等. 他扎罗汀乳膏短时接触疗法治疗寻常痤疮的临床研究［J］. 中华皮肤科杂志, 2009,42（10）:699⁃701. doi: 10.3760/cma.j.issn.0412⁃4030.2009.10.015.
［40］	蒋姝枫, 孙丽蕴, 王萍, 等. 连花平痤饮治疗寻常痤疮湿热蕴结证的临床观察［J］. 中国皮肤性病学杂志, 2018,32（11）:1319⁃1324. doi:10.13735/j.cjdv.1001⁃7089.201801101.
［41］	王向熙, 李臻臻, 赖彦云, 等. 585 nm Q开关激光治疗痤疮炎症性皮损和炎症后红斑的疗效［J］. 北京大学学报（医学版）, 2022,54（2）:283⁃288. doi: 10.19723/j.issn.1671⁃167X.2022.02.014.
［42］	许鹤龄. 活颜凝胶治疗寻常型痤疮的随机对照临床研究［D］.北京: 北京中医药大学, 2023. doi: 10.26973/d.cnki.gbjzu.2023. 000645.
［43］	李鑫泽. 阿达木单抗治疗重度痤疮的临床观察: 一项单中心、单臂、前瞻性开放标签研究［D］. 合肥: 安徽医科大学, 2023. doi: 10.26921/d.cnki.ganyu.2023.000270.
［44］	Koltun W, Maloney JM, Marr J, et al. Treatment of moderate acne vulgaris using a combined oral contraceptive containing ethinylestradiol 20 μg plus drospirenone 3mg administered in a 24/4 regimen: a pooled analysis［J］. Eur J Obstet Gynecol Reprod Biol, 2011,155（2）:171⁃175. doi: 10.1016/j.ejogrb.2010.12.027.
［45］	Leyden JJ, Krochmal L, Yaroshinsky A. Two randomized, double⁃blind, controlled trials of 2219 subjects to compare the combination clindamycin/tretinoin hydrogel with each agent alone and vehicle for the treatment of acne vulgaris［J］. J Am Acad Dermatol, 2006,54（1）:73⁃81. doi: 10.1016/j.jaad.2005. 04.046.
［46］	Xu JH, Lu QJ, Huang JH, et al. A multicentre, randomized, single⁃blind comparison of topical clindamycin 1%/benzoyl peroxide 5% once⁃daily gel versus clindamycin 1% twice⁃daily gel in the treatment of mild to moderate acne vulgaris in Chinese patients［J］. J Eur Acad Dermatol Venereol, 2016,30（7）:1176⁃1182. doi: 10.1111/jdv.13622.
［47］	Feldman SR, Werner CP, Alió Saenz AB. The efficacy and tolerability of tazarotene foam, 0.1%, in the treatment of acne vulgaris in 2 multicenter, randomized, vehicle⁃controlled, double⁃blind studies［J］. J Drugs Dermatol, 2013,12（4）:438⁃446.
［48］	张国毅, 林彤, 孙秋宁, 等. 口服屈螺酮炔雌醇片治疗女性中度寻常痤疮的多中心、随机、安慰剂对照临床研究［J］. 中华皮肤科杂志, 2015,48（2）:85⁃89. doi: 10.3760/cma.j.issn.0412⁃4030.2015.02.005.
［49］	Gollnick HP, Bettoli V, Lambert J, et al. A consensus⁃based practical and daily guide for the treatment of acne patients［J］. J Eur Acad Dermatol Venereol, 2016,30（9）:1480⁃1490. doi: 10. 1111/jdv.13675.
［50］	Kim J, Lee YN, Lee J, et al. Efficacy and safety of silymarin containing antioxidant serum as an adjuvant treatment of mild⁃to⁃moderate acne vulgaris: a prospective, open⁃label pilot study［J］. J Cosmet Dermatol, 2023,22（2）:561⁃568. doi: 10.1111/jocd. 15439.
［51］	Dal Belo SE, Kanoun⁃Copy L, Lambert C, et al. Efficacy of a multitargeted, salicylic acid⁃based dermocosmetic cream compared to benzoyl peroxide 5% in acne vulgaris: results from a randomized study［J］. J Cosmet Dermatol, 2024,23（3）:891⁃897. doi: 10.1111/jocd.16052.
［52］	Hammoda TM, Ahmed NA, Hamdino M. Fractional CO2 laser versus 1064⁃nm long⁃pulsed Nd:YAG laser for inflammatory acne vulgaris treatment: a randomized clinical trial［J］. Lasers Med Sci, 2023,38（1）:187. doi: 10.1007/s10103⁃023⁃03855⁃6.
［53］	Lekakh O, Mahoney AM, Novice K, et al. Treatment of acne vulgaris with salicylic acid chemical peel and pulsed dye laser: a split face, rater⁃blinded, randomized controlled trial［J］. J Lasers Med Sci, 2015,6（4）:167⁃170. doi: 10.15171/jlms.2015.13.

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Chinese expert consensus on clinical severity grading and therapeutic evaluation of acne vulgaris

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