Gaps and recommendations for clinical management of truncal acne from the Personalising Acne: Consensus of Experts panel

Abstract

Background: Truncal acne is common and burdensome for patients; however, there is paucity of evidence and guidance for the management of truncal acne. Currently, clinical practice guidelines provide very little guidance on the assessment or management of truncal acne.Objectives: To identify unmet needs in truncal acne and make recommendations to address clinical and management gaps using an international consensus.Methods: The Personalising Acne: Consensus of Experts panel consisted of 13 dermatologists, who used a modified Delphi approach to reach a consensus on statements related to clinically relevant aspects of truncal acne evaluation and management. A consensus was defined as $75% of the panelists voting ''agree'' or ''strongly agree.'' The voting was electronic and blinded. Results:The panel identified gaps and made recommendations related to truncal acne identification, assessment, and grading; the evaluation of the impact on patients; and treatment goals and factors to be considered for its management. Limitations:The recommendations are based on expert opinion, in the absence of high-quality evidence.Conclusions: We highlighted addressing not just facial acne but also truncal acne during patient consultations. The recommendations made herein may help facilitate the care of patients who present with truncal acne, with or without facial acne.

A review of the topical management of acne and its associated sequelae in the Asia‐Pacific region with a spotlight on trifarotene

“…25,26 Without this best-practice guidance, patients may receive suboptimal acne treatment, potentially resulting in higher psychological morbidity risk, physical scarring, and hyperpigmentation. 3,27,28 In current Asia-Pacific guidelines, topical retinoids are recommended as the first-line treatment for all acne severities, including as monotherapy for the treatment of comedonal acne and in combination with antimicrobials (including antibiotics and benzoyl peroxide [BPO]) for inflammatory acne lesions. 4,21,[24][25][26]29 Topical retinoids are thought to act by inhibiting the formation of microcomedones, mature comedones, and inflammatory lesions.…”

Management of Acne Vulgaris With Trifarotene

“…These included encouraging healthcare professionals to prompt discussion about truncal acne, to grade truncal acne severity separately from facial acne, to individualize treatment based on impact of acne in different regions, and to consider risk for scarring. 29…”

Truncal Acne: An Overview

“…Despite the development of various assessment tools for truncal acne, the abovementioned tools are mostly used as tools for clinical research (Table 1). In real-world clinical practice, the investigator's global assessment (IGA), the Leeds visual severity scale, ECLA scales, and the comprehensive acne severity scale are widely used for assessing the severity of truncal acne [39]. Given the anatomical variations in acne, there are unmet needs to properly evaluate the severity of truncal acne in real-world clinical practice.…”

“…As the truncal regions are usually exposed in summer, there might be a seasonal variation in the burden of truncal acne. The consensus of an expert panel suggested that the visual analog scale (VAS) could be a useful tool for assessing the factors associated with the impact of disease on patients, and thereby help to identify the treatment goal for each patient [39].…”

“…In clinical practice, some clinicians are managing truncal acne based on the guidelines for facial acne. The recent consensus of an expert panel recommended managing truncal acne similar to facial acne [39]. Although the underlying pathogenic mechanisms between facial acne and truncal acne are similar, as there are some differences between the face and trunk, the management of truncal acne should be considered from a slightly different perspective.…”