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  • Some studies reported an increased risk

    2018-11-15

    Some studies reported an increased risk of anxiety and depression in acne vulgaris patients accompanied by an impairment of quality of life in comparison with healthy individuals, although some studies showed no difference. In this study, we evaluated the quality of life with an acne-specific index, the AQOL, in acne vulgaris patients, which demonstrated a decreased mean score, 6.8 (min–max; 0–25). We did not observe an increased risk of anxiety or depression in acne vulgaris patients. Furthermore, in previous studies, it was shown that quality of life was increased and the risk of anxiety and depression was decreased by suitable acne therapies, which also showed that acne affects patients in psychosocial ways. In our study, we did not show any statistically significant changes in the AQOL, HAD-A, and HAD-D scores at the end of the 2nd month of therapy compared with the baseline. This may be due to an inadequate number of patients who attended a second evaluation, or an incomplete Actinomycin D of the symptoms in 2 months. There was no relationship between acne severity and HAD-A or HAD-D scores, and many other studies were consistent with ours. However, in a study by Erdemir et al, the acne severity was not only defined by the physicians, but also defined by the patients, which showed a positive correlation with HAD-A and HAD-D scores. Perception of acne severity may differ from physician to patient. Because the risk of anxiety and depression is correlated to patients\' perceptions of their disease, we should consider this data in evaluation of the patients. In our study, acne severity was defined only by physicians, and this might have affected our findings. In the same manner, although some studies demonstrated that the severity of the disease had a negative effect on quality of life, some did not show any significant correlation. In our study, there was no significant relation between AQOL scores and acne severity. In the relationship between sex and AQOL, HAD-A and HAD-D scores were not significant. Although some studies showed similar findings, some studies also demonstrated a greater risk of anxiety and a greater impairment of quality of life in women than in men with acne vulgaris. We also did not find relationships between age, duration of the disease, or previous therapies and AQOL, HAD-A, or HAD-D scores. These results were consistent with most of the literature. However, Tan et al reported the quality of life in acne patients of an older age, with a disease duration of >5 years, was negatively affected. We demonstrated a positive correlation between AQOL scores and HAD-A and HAD-D scores. Therefore, a greater impairment of quality of life due to acne leads to an increased risk of anxiety or depression. Yazici et al and Erdemir et al also reported a similar correlation and attributed it to patients\' perceptions of their disease. This shows the importance of evaluating patients with psychological and quality of life questionnaires, instead of just one. Recently, it was shown that dermatologic diseases not only affect patients\' lives but also their families in many ways; therefore, studies have been performed to evaluate the effect of the diseases on the quality of life of the family members. These studies evaluating the effect of chronic dermatoses on quality of life of family members were limited to atopic dermatitis and psoriasis. In a study performed by Basra et al with a group of family members who had close relatives with psoriasis, acne, eczema, melanoma, and some other benign and malign dermatologic diseases, the mean FDLQI score was found to be 6.0. In a study by Basra et al in which the FDLQI was improved, the mean FDLQI score of the whole group of patients was 8.02, and in the acne group, it was 8.9 which was found to be the second highest score after the eczema group. For the family members of vitiligo patients, the mean FDLQI score was 10.3 and it was shown that the disease significantly affected the family members. In the literature, we did not find any study performed specifically to evaluate the quality of life in the family members of acne vulgaris patients. In our study, the mean FDLQI was found to be 7.6. For the family members who attended the second evaluation, the first mean FDLQI score was 8.4 and after 2 months, the mean score for the same subgroup was 4.9; the change was statistically significant. This result shows the family members of the acne patients are affected by the disease. Moreover, Basra et al reported the quality of life score in family members correlated with the progression of the disease. We found that quality of life in family members was negatively affected. In our study, patients with acne vulgaris were mostly high school students and the family members were mostly mothers, probably due to the fact that in our country, a high rate of women are housewives and their main duty is to look after their children. Women are usually more emotional than men, and this might have affected our result.