madman
Super Moderator
* The upper back, upper and lower back, and shoulders were the most common areas of truncal acne. Post-inflammatory hyperpigmentation (PIH), papules, and pustules were the most common truncal lesions. The most common clinical manifestations of truncal acne were comedones + papules + pustules + nodules, PIH + papules + pustules + nodules, PIH + papules + pustules, PIH + comedones + papules + pustules + nodules, and scars + PIH + papules + pustules + nodules (P=.030, P=.001, =.001, P=.011, and P=.005, respectively). These lesions were more prevalent in patients with severe acne than in those with mild-to-moderate acne.
* The pathogenesis of acne involves colonization by Propionibacterium acnes, increased sebum production, hyper-cornification in the pilosebaceous follicle, and enhanced inflammatory response.3-5 Although the pathophysiology of facial and trunk acne is thought to be similar, there are differences in the characteristics of the skin on the face and trunk. The distribution of the sebaceous glands, thickness, and skin pH of the face and trunk vary. Moreover, the skin on the trunk is more susceptible to mechanical stimuli such as perspiration, pressure, friction, and occlusion than facial skin.6 Truncal acne can present as noninflammatory comedones or inflammatory papules, pustules, and nodules on the chest or back.7
Figure 1. Definition of the location of truncal acne lesions.
Abstract
Background
Truncal acne is often overlooked, although it is as common as facial acne.
Objectives
We aimed to investigate the prevalence of truncal acne in patients with mild, moderate, and severe acne and to evaluate the characteristics of truncal acne.
Methods
Patients aged ≥ 12 years who were diagnosed with acne vulgaris at our dermatology outpatient clinics between May 2023 and October 2023 were categorized into two groups based on the severity of facial acne.
Results
Of the patients, 69.9% (n=381) were female and 30.1% (n=164) were male. The mean age was 21.0 ± 5.1 years. The upper back, upper and lower back, and shoulders were the most common areas of truncal acne. Post-inflammatory hyperpigmentation (PIH), papules, and pustules were the most common truncal lesions. The most common clinical manifestations of truncal acne were comedones + papules + pustules + nodules, PIH + papules + pustules + nodules, PIH + papules + pustules, PIH + comedones + papules + pustules + nodules, and scars + PIH + papules + pustules + nodules (P=.030, P=.001, =.001, P=.011, and P=.005, respectively). These lesions were more prevalent in patients with severe acne than in those with mild-to-moderate acne.
Conclusion
When evaluating acne, examining the lower and upper back, the front half of the trunk, and the shoulders is essential, while not ignoring PIH. Diagnosing and treating truncal acne significantly increases the patient’s quality of life and self-confidence.
Introduction
Acne is a prevalent inflammatory skin disease that affects over 640 million people worldwide, with up to 85% of adolescents affected. However, while there has been research on facial acne, there is a lack of studies on acne affecting the trunk.1 Notably, many patients experience truncal acne. A systematic review conducted in 2020 found that the prevalence of trunk acne ranged between 45% and 61%.
The pathogenesis of acne involves colonization by Propionibacterium acnes, increased sebum production, hyper-cornification in the pilosebaceous follicle, and enhanced inflammatory response.3-5 Although the pathophysiology of facial and trunk acne is thought to be similar, there are differences in the characteristics of the skin on the face and trunk. The distribution of the sebaceous glands, thickness, and skin pH of the face and trunk vary. Moreover, the skin on the trunk is more susceptible to mechanical stimuli such as perspiration, pressure, friction,and occlusion than facial skin.6 Truncal acne can present as noninflammatory comedones or inflammatory papules, pustules, and nodules on the chest or back.7
Currently, there are no clear guidelines for the clinical management of truncal acne, and international consensus studies on this subject are ongoing.8 Moreover, there are significantly fewer studies on patients with truncal acne than on those with facial acne vulgaris. Conducting studies that examine the clinical characteristics of truncal acne lesions can help to enhance the approach and treatment of this condition.
Conclusion
Dermatologists should encourage patients to undergo truncal acne examination. Examining the lower and upper back, front half of the trunk, and shoulders is necessary when evaluating acne. Additionally, because PIH is expected, including ingredients in the treatment may be beneficial. This approach will enhance the success of acne treatment (reducing the risk of PIH), improve the patient’s quality of life, and boost their self-esteem.
* The pathogenesis of acne involves colonization by Propionibacterium acnes, increased sebum production, hyper-cornification in the pilosebaceous follicle, and enhanced inflammatory response.3-5 Although the pathophysiology of facial and trunk acne is thought to be similar, there are differences in the characteristics of the skin on the face and trunk. The distribution of the sebaceous glands, thickness, and skin pH of the face and trunk vary. Moreover, the skin on the trunk is more susceptible to mechanical stimuli such as perspiration, pressure, friction, and occlusion than facial skin.6 Truncal acne can present as noninflammatory comedones or inflammatory papules, pustules, and nodules on the chest or back.7
Figure 1. Definition of the location of truncal acne lesions.
Abstract
Background
Truncal acne is often overlooked, although it is as common as facial acne.
Objectives
We aimed to investigate the prevalence of truncal acne in patients with mild, moderate, and severe acne and to evaluate the characteristics of truncal acne.
Methods
Patients aged ≥ 12 years who were diagnosed with acne vulgaris at our dermatology outpatient clinics between May 2023 and October 2023 were categorized into two groups based on the severity of facial acne.
Results
Of the patients, 69.9% (n=381) were female and 30.1% (n=164) were male. The mean age was 21.0 ± 5.1 years. The upper back, upper and lower back, and shoulders were the most common areas of truncal acne. Post-inflammatory hyperpigmentation (PIH), papules, and pustules were the most common truncal lesions. The most common clinical manifestations of truncal acne were comedones + papules + pustules + nodules, PIH + papules + pustules + nodules, PIH + papules + pustules, PIH + comedones + papules + pustules + nodules, and scars + PIH + papules + pustules + nodules (P=.030, P=.001, =.001, P=.011, and P=.005, respectively). These lesions were more prevalent in patients with severe acne than in those with mild-to-moderate acne.
Conclusion
When evaluating acne, examining the lower and upper back, the front half of the trunk, and the shoulders is essential, while not ignoring PIH. Diagnosing and treating truncal acne significantly increases the patient’s quality of life and self-confidence.
Introduction
Acne is a prevalent inflammatory skin disease that affects over 640 million people worldwide, with up to 85% of adolescents affected. However, while there has been research on facial acne, there is a lack of studies on acne affecting the trunk.1 Notably, many patients experience truncal acne. A systematic review conducted in 2020 found that the prevalence of trunk acne ranged between 45% and 61%.
The pathogenesis of acne involves colonization by Propionibacterium acnes, increased sebum production, hyper-cornification in the pilosebaceous follicle, and enhanced inflammatory response.3-5 Although the pathophysiology of facial and trunk acne is thought to be similar, there are differences in the characteristics of the skin on the face and trunk. The distribution of the sebaceous glands, thickness, and skin pH of the face and trunk vary. Moreover, the skin on the trunk is more susceptible to mechanical stimuli such as perspiration, pressure, friction,and occlusion than facial skin.6 Truncal acne can present as noninflammatory comedones or inflammatory papules, pustules, and nodules on the chest or back.7
Currently, there are no clear guidelines for the clinical management of truncal acne, and international consensus studies on this subject are ongoing.8 Moreover, there are significantly fewer studies on patients with truncal acne than on those with facial acne vulgaris. Conducting studies that examine the clinical characteristics of truncal acne lesions can help to enhance the approach and treatment of this condition.
Conclusion
Dermatologists should encourage patients to undergo truncal acne examination. Examining the lower and upper back, front half of the trunk, and shoulders is necessary when evaluating acne. Additionally, because PIH is expected, including ingredients in the treatment may be beneficial. This approach will enhance the success of acne treatment (reducing the risk of PIH), improve the patient’s quality of life, and boost their self-esteem.
