A Consensus Panel of the American Academy of Dermatology (AAD) proposed criteria for the classification of acne in 1990. One conclusion of the Consensus Panel was that a purely quantitative definition of acne severity cannot be used, because of the variability in disease expression.
Types of Acne
Noninflammatory acne: presence of open or closed comedones only
Inflammatory acne: presence of papules, pustules and/or nodules (cysts)
Papules: inflammatory lesions < 5 mm in diameter
Pustules: inflammatory lesions < 5 mm in diameter, with a visible central core of purulent material
Nodules: inflammatory lesions >= 5 mm in diameter
|
Severity of Disease |
Number of Lesions |
|
mild |
few to several papules/pustules, AND no nodules |
|
|
few to many comedones |
|
moderate |
several to many papules/pustules |
|
|
few to several nodules |
|
|
numerous and extensive comedones |
|
severe |
numerous and/or extensive papules/pustules |
|
|
many persistent or recurrent nodules |
|
|
large and very extensive comedones |
|
|
ongoing scarring |
|
|
persistent purulent and/or serosanguinous drainage from lesions |
|
|
presence of sinus tracts |
|
very severe |
acne conglobata |
|
|
acne fulminans |
|
|
acne inversa (follicular occlusion triad) |
where:
• Acne conglobata: a highly inflammatory condition with comedones, cysts, abscesses and draining sinus tracts. Healing occurs with resultant severe scarring.
• Acne fulminans: acute, febrile ulcerative acne with the sudden appearance of massive inflammatory and tender lesions of the back and chest which rapidly ulcerate and heal by scarring.
Additional factors affecting classification:
(1) psychosocial circumstances
(2) occupational difficulties
(3) inadequate therapeutic responsiveness
Specialty: Dermatology, Infectious Diseases, Pedatrics, Otolaryngology
