Table 1.
Summary of recently developed assessment tool for truncal acne.
| Tool | Sites | Grading | Descriptions of the Grading |
|---|---|---|---|
| LRAG | Each of face, chest, and back | Based on photographic templates Based on the number of inflamed lesions and their inflammatory intensity (Grade 1–12) Predominant noninflamed lesions (Grade 1–3) |
Grade 1, least severe–Grade 12, most severe Grade 1, least severe–Grade 3, most severe |
| CLASS | Each of face, chest, and back | Clear (0) Almost clear (1) Mild (2) Moderate (3) Severe (4) Very severe (5) |
No lesions to barely noticeable ones, very few scattered comedones and papules Hardly visible from 2.5 m away. A few scattered comedones, few small papules, and very few pustules Easily recognizable; less than half of the affected area is involved. Many comedones, papules, and pustules; 0–5 papules and pustules More than half of the affected area is involved; numerous comedones, papules and pustules; 6–20 papules and pustules The entire area is involved. Covered with comedones, numerous pustules, and papules, a few nodules and cyst; 21–50 papules and pustules Highly inflammatory acne covering the affected area, with nodules and cyst present; >50 inflammatory lesions |
| SCAR-S | Each of face, chest, and back | The overall scar score is the sum of scores from each of these three sites. Clear (0) Almost clear (1) Mild (2) Moderate (3) Severe (4) Very severe (5) |
No visible scars from acne Hardly visible scars from 2.5 m away Easily recognizable; less than half the affected area (e.g., face, back, or chest) involved More than half the affected area (e.g., face, back, or chest) involved Entire area involved Entire area with prominent atrophic or hypertrophic scars |
| TRASS | Trunk (upper back, lower back, and chest) | Sum of the three sub-score items (ranging from 0–19) Sub-score 1: criteria of severity based on disease and family history (maximum score 6) Sub-score 2: Clinical marker of acne severity (maximum score 11) Sub-score 3: quality of life (maximum score 2) |
Item 1: Duration of acne (0, 0–2 years; 1, 3–5 years; 2, ≥6 years) Item 2: Family history (0, none; 1, present) Item 3: Past systemic acne treatment (0, none; 1, oral systemics; 2, isotretinoin) Item 4: Areas on the trunk Upper back (0, no lesion; 1, lesion) Lower back (0, no lesion; 1, lesion) Chest (0, no lesion; 1, lesion) Item 5: Number of nodules (0, 0; 1, 1–5; 2, 6–9; 3, ≥10) Item 6: Scars (Hypertrophic/keloid: 0, no; 1, yes; atrophic: 0, no; 1, yes; elastosis: 0, no; 1, yes; hyperpigmentation/erythema: 0, no; 1, yes) Item 7: Facial acne (0, no; 1, yes) Item 8: Severity of impact on quality of life (0, none; 1, moderate; 2, important) |
Abbreviation: CLASS, the comprehensive acne severity scale; LRAG, Leeds Revised Acne grading; SCAR-S, six-category global severity scale; TRASS, truncal acne severity scale.