Truncal acne, what do we know?

Abstract

Truncal acne is frequently overlooked in dermatological practice, even though it may result in scars and impact on self-esteem and body image. Therefore, it is important to identify the disease early in order to initiate treatment in time and, thus, to prevent it from worsening and resulting in physical and psychological sequelae. The aim of this review is to provide an overview of what is currently known about truncal acne, its prevalence, aetiology and physiopathology, how its severity is currently evaluated, how to differentiate it from other skin afflictions and current treatment options. A review of literature considering the issue of truncal acne published up to 2019 and available from PubMed was conducted, and in total, 76 articles were selected from PubMed. Currently, only little information about truncal acne is available. Considered as having the same pathophysiology as facial acne, the clinical picture and treatment response seem to differ. Specific acne severity grading systems and quality of life questionnaires as well as a specific treatment algorithm are still lacking. Filling this gap should allow clinicians to assess truncal acne in the best possible way, choosing suitable treatment options, helping patients to improve treatment adherence and quality of life and finally allowing a better management of truncal acne. In conclusion, more knowledge is required to treat more efficiently truncal acne.

Impact of facial and truncal acne on quality of life: A multi-country population-based survey

“…Most prior HRQoL studies on acne have focused on facial acne. 25 , 26 However, just as with facial acne, acne can affect the chest and back with varying severity, and the location of acne has been shown to differentially impact the patient's HRQoL experience. 27 , 28 , 29 Evaluation of acne severity and impact beyond facial involvement can provide a means to develop a comprehensive patient management strategy.…”

The Personalised Acne Care Pathway—Recommendations to guide longitudinal management from the Personalising Acne: Consensus of Experts

“…[1][2][3][4][5] Clinically, acne typically presents in various forms, with truncal acne presenting in more than half of the patients with facial involvement. [6][7][8][9][10][11] Despite its varying presentations and chronic nature, current guidelines offer little guidance to facilitate personalized or longitudinal management of patients. 6,12,13 Personalized care is important in chronic skin conditions, where treatment success is highly dependent on patient adherence to ongoing treatment regimens.…”

“…15 Moreover, disease chronicity and the disease itself (including its anatomic location) play an important role, as can the health care system in which the patient is receiving care (eg, appointment availability and treatment costs). 11,15,16 Low adherence can be due to a perceived lack of response or low treatment satisfaction, highlighting the need for HCPs to consider and discuss patients' concerns, set realistic expectations, and dispel misconceptions throughout their treatment journey. 17,18 Ongoing care is also important in managing acne effectively to minimize disease relapse.…”

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

“…Nearly three-quarters (73%) of adults (over 20 years of age) report ever having acne, 1 , 2 , 3 with as many as 61% presenting with truncal involvement. 4 , 5 , 6 , 7 , 8 The latter is inclusive of the shoulders, chest, and back. 9 Despite the high prevalence of truncal acne, there is paucity of data on its clinical aspects, including management options.…”