Lipid Droplet Proteins in Acne Skin: A Sound Target for the Maintenance of Low Comedogenic Sebum and Acne-Prone Skin Health

In adipocytes and sebocytes, lipid droplet proteins control the storage of lipids in organized droplets and their release on demand. The contribution of lipid droplet proteins to the pathogenesis of acne is plausible because they control the levels of comedogenic free fatty acids. The expression of two lipid droplet proteins, CIDEA and PLIN2, was analyzed in the skin of patients with acne by immunohistochemistry and western blotting. The design of clinical protocols allowed correlating the expression of CIDEA and PLIN2 with both comedogenesis and the release of free fatty acids. Both proteins were detected by immunohistochemistry in the sebaceous glands of patients with acne, with a disturbed expression pattern of PLIN2 compared with that in the controls. Higher levels of PLIN2 and CIDEA, as detected by western blotting in the infundibulum, significantly correlated with lower ongoing comedogenesis over 48 weeks of Silybummarianum fruit extract application. Accordingly, free fatty acid release from sebum triglycerides was significantly decreased, as shown with two distinct methods. The data are consistent with the expected role of PLIN2 and CIDEA in the prevention of comedogenic free fatty acid release. Modulation of PLIN2 and CIDEA expression appears as a sound target for the maintenance of low comedogenic sebum and acne-prone skin health.

IL-17+ Mast Cell/T Helper Cell Axis in the Early Stages of Acne

Acne is a multifactorial disease driven by physiological changes occurring during puberty in the pilosebaceous unit (PSU) that leads to sebum overproduction and a dysbiosis involving notably Cutibacterium acnes. These changes in the PSU microenvironment lead to a shift from a homeostatic to an inflammatory state. Indeed, immunohistochemical analyses have revealed that inflammation and lymphocyte infiltration can be detected even in the infraclinical acneic stages, highlighting the importance of the early stages of the disease. In this study, we utilized a robust multi-pronged approach that included flow cytometry, confocal microscopy, and bioinformatics to comprehensively characterize the evolution of the infiltrating and resident immune cell populations in acneic lesions, beginning in the early stages of their development. Using a discovery cohort of 15 patients, we demonstrated that the composition of immune cell infiltrate is highly dynamic in nature, with the relative abundance of different cell types changing significantly as a function of clinical lesion stage. Within the stages examined, we identified a large population of CD69⁺ CD4⁺ T cells, several populations of activated antigen presenting cells, and activated mast cells producing IL-17. IL-17⁺ mast cells were preferentially located in CD4⁺ T cell rich areas and we showed that activated CD4⁺ T cells license mast cells to produce IL-17. Our study reveals that mast cells are the main IL-17 producers in the early stage of acne, underlying the importance of targeting the IL-17⁺ mast cell/T helper cell axis in therapeutic approaches.

Benefits of Avène thermal hydrotherapy in chronic skin diseases and dermatological conditions: an overview

The beneficial effects of Avène Thermal Spring Water (TSW), a low mineral content spring water, on chronic skin diseases have been recognized for more than two centuries. This article provides a brief overview of efficacy and tolerance data for Avène TSW from clinical studies conducted at the Avène Hydrotherapy Center in patients with chronic inflammatory skin diseases or temporary skin injuries. Avène TSW hydrotherapy is effective as adjuvant management for chronic skin diseases and dermatological conditions, relieving subjective and physical symptoms with excellent tolerance.

High bacterial colonization and lipase activity in microcomedones

BACKGROUND

Although acne vulgaris has a multifactorial aetiology, comedogenesis and bacteria colonization of the pilosebaceous unit are known to play a major role in the onset of inflammatory acne lesions. However, many aspects remain poorly understood such as where and when is the early stage of the Propionibacterium acnes colonization in follicular unit? Our research aimed at providing a precise analysis of microcomedone's structure to better understand the interplay between Propionibacterium acnes and follicular units, and therefore, the role of its interplay in the formation of acne lesions.

METHODS

Microcomedones were sampled using cyanoacrylate skin surface stripping (CSSS). Their morphology was investigated with multiphoton imaging and their ultrastructure with scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Bacterial lipase activity in the microcomedones was quantified using a dedicated enzymatic test as well as a Fourier Transform Infra-Red (FTIR) analysis. The porphyrin produced by bacteria was analysed with HPTLC and fluorescence spectroscopy.

RESULTS

The imaging analysis showed that microcomedones' structure resembles a pouch, whose interior is mostly composed of lipids with clusters of bacteria and whose outer shell is made up of corneocyte layers. The extensive bacteria colonization is clearly visible using TEM. Even after sampling, clear lipase activity was still seen in the microcomedone. A high correlation, r = .85, was observed between porphyrin content measured with HPTLC and with fluorescence spectroscopy. These observations show that microcomedones, which are generally barely visible clinically, already contain a bacterial colonization.

Efficacy and Tolerability of a Medical Device Repairing Emollient Cream Associated with a Topical Corticosteroid in Adults with Atopic Dermatitis: An Open-label, Intra-individual Randomized Controlled Study

Introduction

Medical device repairing emollient creams (MDRECs) are designed to repair and protect the skin barrier. In this study, we examined the added clinical benefit and tolerability of a MDREC when used in association with a moderately potent topical corticosteroid (TCS) for adults with atopic dermatitis (AD).

Methods

This was an intra-individual randomized controlled trial in adults with moderate to severe AD (EudraCT no. 2014-002,194-10). Symmetrical lesions on each arm of the subjects were randomized to treatment for 10 days with twice-daily TCS (desonide) cream alone or with combined TCS + MDREC. Subjects were then included in a following 2-week maintenance phase if the AD on at least one test area had sufficiently improved so that the treatment was no longer needed. During the maintenance phase, treatment with the TCS cream was stopped, but twice-daily application of the MDREC was continued on the same test area previously assigned to receive it. The primary outcome measure was the change in local Scoring Atopic Dermatitis (SCORAD) index between day 1 and 3 based on investigators’ assessment. Secondary measures of lesion severity included changes in the local patient-oriented SCORAD index, pruritus intensity according to subjects’ assessments, and global assessments by subjects and investigators.

Results

The study included 54 subjects. The change in investigator-observed local SCORAD index between day 1 and 3 was − 14.4% with TCS alone and − 24.5% for TCS + MDREC (p = 0.0005). Between baseline and the end of the treatment phase, all secondary measures of lesion severity decreased more with the combined TCS + MDREC treatment than with the TCS cream alone. The MDREC also reduced the relapse of AD lesions during the maintenance phase. Tolerability was very good, and the product was well accepted by subjects.

Conclusion

These results support using the MDREC in association with TCS during AD flares and as a maintenance therapy after treatment with TCS has stopped.

Funding

Laboratoires Dermatologiques Ducray, Pierre Fabre.

Visualization of dendritic cells' responses in atopic dermatitis: Preventing effect of emollient

Atopic dermatitis (AD) is a chronic and multifactorial inflammatory skin disease involving various dendritic cells such as epidermal Langerhans cells (LC) and inflammatory dendritic epidermal cells (IDECs). Most of the clinical studies was performed on isolated cells, and thus, it would be useful to characterize directly on the human epidermal tissue the first cellular events occurred during the AD. The suction blister method was used to obtain whole epidermis samples and interstitial cutaneous fluids. Employing multiphoton microscopy, we analyzed the early dynamic behavior of inflammatory cells using Dermatophagoides pteronyssinus atopy patch test (Derp-APT) and evaluated the effects of emollient pre-application. Derp-APT application provoked rapid and strong infiltration of IDECs, and proliferation and activation of LC in the AD subjects' epidermis. Moreover, emollient pre-application strengthened the defective skin barrier and had positive effects on inflammatory cells' behavior, characterized by the complete inhibition of IDEC influx and the presence of immature LC.

Sensitive skin in Europe

INTRODUCTION

Sensitive skin appears as a very frequent condition, but there is no comparative data between countries.

OBJECTIVES

To perform an epidemiological approach to skin sensitivity in different European countries.

METHODS

An opinion poll was conducted in eight European countries: Belgium, France, Germany, Greece, Italy, Portugal, Spain and Switzerland. This sample (4506 persons) was drawn from a representative sample of each population aged 15 years or older.

RESULTS

Sensitive or very sensitive skin was declared by 38.4% and slightly or not sensitive skin by 61.6%. Women declared more sensitive skin than men. A dermatological disease was declared by 31.2% of people with very sensitive skin, 17.6% of those with sensitive skin, 8.7% of those with slightly sensitive skin and 3.7% of those who do not have sensitive skin. A history of childhood atopic dermatitis was more frequent in patients with sensitive or very sensitive skin. The interviewees who declared that they had dry or oily skin also reported significantly more frequently sensitive or very sensitive skin than those with normal skin. Sensitive and very sensitive skins were clearly more frequent in Italy and France.

DISCUSSION

This study is the first study that compares skin sensitivity in European countries. Prevalence is high, but significant differences are noted between these countries. Dermatological antecedents (or treatments?) could be involved in the occurrence of skin sensitivity.

[Medical corrective make-up in post- chemotherapy]

INTRODUCTION

Medical corrective make up can be applied to hide the adverse effects of cancer treatments. The aim of this study was to evaluate the tolerance and the satisfaction of patients needing medical make up to hide the cutaneous side effects induced by chimiotherapy and to improve self-esteem.

METHODS

90 cancer patients were included in this multicentric study. They were being treated by chimiotherapy and had eyebrow alopecia, complexion changes, irregular lip contour or lip dryness. They were made up by socio-esthecians. Photos were taken before and after applications of make up. The patients had to fill in a self-questionnaire at home. The duration of the study varied from 1 to 4 weeks.

RESULTS

Included patients were 52 years old. Tolerance was considered to be satisfactory or very satisfactory by 95,4% and 98,9% of the patients for eyebrow pencil corrector and the dual lip and contour corrector, respectively. Questions on quality of live and self-esteem revealed that the medical corrective make up improved the quality of life in general for 81,2% of the patients. This product range enhanced the self-esteem of 76,8% of the patients. Cosmetic agreement was highly satisfactory.

CONCLUSION

In this study in which patients were suffering from cancer and treated by chimiotherapy, we showed that medical corrective make up can improve the quality of life with a very good tolerance.

Corrélation clinique et psychologique dans l’acné : utilisation des grilles ECLA et CADI

BACKGROUND

The psychological consequences of acne are frequently unrelated to the severity of the actual lesions. Thus, a number of scales have been designed and validated to allow quantitation of the severity of acne, such as the ECLA scale (Echelle de Cotation des Lésions d'Acné or Acne Lesion Score Scale) while others are designed to evaluate quality of life, such as the CADI (Cardiff Acne Disability Index) questionnaire recently validated in the French language. The purpose of this study was to use both of these scales in individual applications in order to determine whether or not any correlation exists between the two specific tools and to determine the two groups of patients affected by acne.

METHODS

One hundred and twenty-eight acne patients (21+/-6.8 years) seen by seven dermatologists were included in this study. The severity of their acne was evaluated using the ECLA scale; the seven participating dermatologists were trained in the use of this scoring system. In addition, patients completed the CADI quality-of-life questionnaire after their consultation. Each factor on the ECLA was compared with each item in the CADI questionnaire by means of analysis of variance.

RESULTS

There was no correlation between overall scores on the ECLA and CADI scales (r(2)=0.0242). However, a positive correlation was observed between overall CADI score and factors F1 and F3 in the ECLA scale (p=0.0085 and p=0.0373 respectively). In contrast, the global score on the ECLA scale was significantly correlated with item 5 of the CADI questionnaire, namely patients' perception of their acne (p=0.0035).

CONCLUSION

Acne, even in mild forms, has a detrimental psychological effect on patients. The ECLA score coupled with the CADI assessment system appear to be two useful and complementary scores for use in complete acne patient management.

Combined 0.1% Retinaldehyde/ 6% Glycolic Acid Cream in Prophylaxis and Treatment of Acne Scarring

BACKGROUND

Acne often results in permanent, badly tolerated, difficult to treat scars.

OBJECTIVE

To evaluate the efficacy and safety of a 0.1% retinaldehyde/6% glycolic acid (RALGA) cream at preventing and treating acne scarring in patients previously treated for moderate acne.

METHODS

A double-blind vehicle-controlled study was conducted in 145 patients randomized to apply RALGAor vehicle cream every evening for 3 months. Global scarring score and patient's assessment of global efficacy, then residual acne lesions, quality of life and tolerance were evaluated at inclusion and each month until study completion.

RESULTS

Global scarring score, number of inflammatory lesions and comedones significantly improved in each group from day 28 (p<0.0001). Number of inflammatory lesions were significantly decreased only in the RALGA group. RALGA cream was more efficient than vehicle on scarring after 3 months in compliant patients (p=0.007) due to erythema and hyperpigmentation improvement.

CONCLUSION

RALGA cream is efficient at preventing and treating acne scarring in patients with moderate acne.

Comparative benefit of two thermal spring waters after photodynamic therapy procedure

INTRODUCTION

Photodynamic therapy (PDT) is commonly used to treat actinic keratoses, superficial cutaneous carcinoma, photodamage, and/or acne. The aim of this study was to compare the usefulness of Avène thermal spring water (ATSW), a low mineral content spring water, to a high mineral content spring water. We evaluated post-PDT clinical symptoms and findings when used as an adjunctive therapy in postprocedure skin care.

METHODS

A double-blind monocentric comparative study was conducted on 25 patients suffering from either vulgaris acne or photodamage with or without actinic keratoses. The patients were treated with 5-aminolevulinic acid (5-ALA) activated with an intense pulsed light and/or blue light source. Patients were randomized so that 12 patients treated their faces with ATSW and 13 were treated with a comparative water spray. Clinical signs were evaluated by the investigator at day 0, before and 15 min after the first spraying, at days 2, 4, and 7, and each day from day 0 to day 6 by patients. Clinical signs (erythema, stinging, pruritus, pain, and tightening) were evaluated by the use of a 4-point grading scale.

RESULTS

The intragroup analysis showed that pain was significantly reduced by ATSW spraying at days 2, 4, and 7. The evaluation by patients showed that only ATSW alleviates pain from day 3 to day 6. The between-group analysis revealed that pruritus was significantly reduced by ATSW at day 7. Erythema, stinging, and tightening were not significantly reduced by both waters. Patients wished to continue using ATSW in 83% of cases.

CONCLUSION

This comparative clinical trial demonstrates that ATSW, a low mineral content spring water, can be useful after ALA-PDT in reducing postprocedure cutaneous inflammation and patient discomfort better than a high mineral content spring water.

Sensitive skin: psychological effects and seasonal changes

INTRODUCTION

Sensitive skin is a frequent disorder, but its effects and its variability are unknown.

OBJECTIVES

To investigate the effects of sensitive skin first on quality of life and the psyche, and secondly, on seasonal changes.

METHODS

The French Opinion Poll Institute (IPSOS) conducted two opinion polls in March and July 2004. Samples included, respectively, 1006 and 1001 individuals, from a representative national sample of the French population aged 15 years or older. The polling subjects were interviewed by phone and selected by the quota method (gender, age, occupation of household head, type of geographical area and region). Questions about their perception of their sensitive skin and about potential aggravating factors were asked. Quality of life was assessed using the SF-12 questionnaire and depressive symptoms using the Hospital Anxiety and Depression (HAD) rating scale.

RESULTS

The characteristics of the two samples were strictly similar. Persons with sensitive skin and very sensitive skin were more numerous in summer than in winter. In both surveys, the degree of sensitivity was significantly higher in the female population. Quality of life was worse in people with sensitive or very sensitive skin, above all in its psychological component - the more sensitive the skin, the more the quality of life deteriorated. There was no significant relationship between depressive symptoms and skin sensitivity in the 'very sensitive' or 'sensitive' groups.

CONCLUSION

Our study was the first to show seasonal changes in skin reactivity and to study the psychological impacts of sensitive skin.

ECCA Grading Scale: An Original Validated Acne Scar Grading Scale for Clinical Practice in Dermatology

INTRODUCTION

The ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné) is a tool designed to help dermatologists to assess the severity of acne scars and to standardize the discussions about the treatments of scars.

METHODS

We developed an acne scar clinical grading scale called ECCA, which consists of 6 items designed to assess easily and quickly the severity of acne scars by a global score. The interobserver reliability of the ECCA grading was statistically validated.

RESULTS

The statistical analysis showed the interinvestigator reliability of the ECCA grading scale among 7 dermatologists who used it on the same group of 10 acne patients.

CONCLUSION

ECCA is a new tool which will now be available for dermatologists to use in their everyday practice and for clinical trials evaluating the efficacy of treatments on acne scars.

Peaux sensibles en France : approche épidémiologique

INTRODUCTION

Sensitive skin is a frequently evoked cosmetic disorder, but its prevalence in France is unknown.

METHODS

Using a survey of a representative sample of the French population aged over 15 carried out by ISPSOS-Santé, we assessed the frequency of sensitive skin. We used the quota method (gender, age, occupation of the head of the family) and stratification by area and category of the agglomeration.

RESULTS

One thousand and six persons were surveyed. The non-response rate was less than 1 p.cent. Fifty-two percent claimed they had sensitive or very sensitive skin. Women were predominantly concerned (59 vs. 44 p.cent, p<0.0001). There was no significant difference between the socio-professional categories. Twenty-eight p.cent of the population claiming their skin was very sensitive declared they had a concomitant dermatological disease, whereas 14 p.cent with sensitive skin, 7 p.cent with not very sensitive skin and 2 p.cent with normal skin declared likewise. Skin sensitivity was triggered by emotion, cold, heat or cosmetics. A quality-of-life assessment using the SF-12 scale showed significant alteration in the psychological dimension (but not physical) of the score for those with sensitive and very sensitive skin compared with the others, notably in the women (p<0.0001).

DISCUSSION

This survey revealed a prevalence of sensitive skin in France equal to that found in England. It only measured the subjective feeling of sensitive skin experienced by those surveyed, since there was no clinical examination. The phenomenon appears frequent. Although women appeared to suffer more, a large proportion of men also suffered from sensitive skin.

RALGA (Diacnéal®) Decreases Melanin Content in a Human Skin Model

BACKGROUND

Retinaldehyde and glycolic acid RALGA (Diacneal) are both effective in the topical treatment of acne. A decrease in the postinflammatory pigmentation has been observed after application of Diacneal during 3 months.

AIM

To verify the effect of this association on pigmentation using an original model of surviving human skin.

METHODS

Human skin explants were maintained alive in organ culture for 14 days. Diacneal was applied every day. Pigmentation of skin, depending on the transfer of melanosomes from melanocytes to keratinocytes, was visualized histologically by Fontana-Masson staining. The number of melanocytes was determined after the DOPA reaction.

RESULTS

A decrease in melanin content was shown after application of Diacneal. The number of melanocytes was not modified.

CONCLUSION

These results suggest that RALGA (Diacneal) may be of interest to prevent the postinflammatory pigmentation of acne.

Topical Retinaldehyde with Glycolic Acid: Study of Tolerance and Acceptability in Association with Anti-Acne Treatments in 1,709 Patients

BACKGROUND

Retinaldehyde (RAL), a key metabolite between vitamin A and retinoic acid, acts by modulating differentiation and proliferation of keratinocytes, which is of interest in acne lesions, mainly retentional lesions. Glycolic acid increases the exfoliation of corneocytes explaining its mild activity on retentional lesions. Thus, RAL and glycolic acid combined in the same product (Diacneal) have complementary activities which can be of interest for acne patients. The aim of this study was to evaluate the tolerance of Diacneal used by 1,709 acne patients in combination with their usual acne products except retinoids.

RESULTS

This study demonstrated a very good tolerance of Diacneal when used with other acne treatments for 90 days. Complaints about side-effects were rare. Moreover, the significant decrease in both inflammatory and retentional lesions between day 0 and day 90 indicates that Diacneal could amplify the efficiency of other anti-acne products used at the same time by the patients. The subjective evaluation of the preparation's efficacy by investigators and patients was strongly favourable.

CONCLUSION

These data show that a combination of RAL 0.1% and glycolic acid 6% may be used in association with other topical anti-acne treatments (benzoyl peroxide and topical antibiotics) with an excellent tolerance.

Comparative study of the anti-aging effect of retinaldehyde alone or associated with pretocopheryl in a surviving human skin model submitted to ultraviolet A and B irradiation

In the past few years, the cellular effects of ultraviolet (UV) irradiation induced on skin have become increasingly recognized. Indeed, it is now well known that UV irradiation induces structural and cellular changes in all the compartments of skin tissue. Our aim was to study the anti-aging efficacy of a cosmetic cream containing 0.05% retinaldehyde associated with an antioxidant such as pretocopheryl in comparison with a cream containing only 0.05% retinaldehyde. For this purpose, an ex vivo technique using human skin was used to approximate in vivo metabolic conditions. In this model, human skin was maintained alive by organ culture for 14 days and skin aging was simulated with UV irradiation. Creams were applied to the surface of the epidermis and were compared with nontreated skin. After 14 days, free radical modulation was analyzed by hydroperoxide dosage. Epidermal (laminin) and dermal changes (elastic fibers and collagen) were studied by a histological method. Moreover, to examine collagen synthesis, tritiated proline was added to the culture medium and its incorporation in the newly synthesized collagen was evaluated by Webster's method. The formula containing 0.05% retinaldehyde and pretocopheryl significantly decreased UV-generated free radicals. Repair of laminin, elastic fiber and collagen network was significant and the results were better than those obtained with retinaldehyde alone. An increase of collagen synthesis was also shown with the two creams.

Efficacy of Sunscreens Containing Pre-Tocopheryl in a Surviving Human Skin Model Submitted to UVA and B Radiation

The aim of the present study was to evaluate by means of histological and biochemical tools the additive efficacy of pre-tocopheryl during photoprotection using a sunscreen containing mineral sunblock agents 50B-10A (TiO(2), ZnO) and pre-tocopheryl in comparison to a cream containing only mineral sunblock agents 50B-10A. For this purpose, an ex vivo technique and an acetone-impaired human skin model were used in order to approximate in vivo metabolic conditions. Creams were topically applied to the surface of the epidermis and submitted to UV radiations. Then, human skin explants were maintained alive in organ culture for 3 days. Free radical modulation was analysed by hydroperoxide assay. Epidermal (involucrin, cell proliferation, stratum corneum lipids) and dermal changes (elastic fibres and collagen) were studied. Analysis of ex vivo surviving skin samples impaired by UV irradiations and treated with the mineral sunscreen 50B-10A showed a significant decrease in hydroperoxide production and an improvement in the elastic fibre and collagen network in the dermis. Adding pre-tocopheryl to this formula induced an increase in involucrin and epidermal lipids such as squalenes and ceramides. Altogether, these results confirm the efficacy of the combination of a mineral sunscreen and pre-tocopheryl in photoprotection and free radical protection.

Ultrasound imaging demonstration of the improvement of non-ablative laser remodeling by concomitant daily topical application of 0.05% retinaldehyde

BACKGROUND

Retinaldehyde has been proven to be effective in the reduction of facial wrinkles. It has also demonstrated its usefulness when used before and after laser skin resurfacing.

OBJECTIVE

A monocentric, comparative, randomized, double-blind study was performed to evaluate the efficacy of retinaldehyde versus excipient in combination with non-ablative laser remodeling treatment.

METHODS

A total of 16 female patients (mean age 45 years) were enrolled for neck line and forehead rhytid treatment. They were randomly assigned into two groups. The RAL group (eight patients) was treated with a non-ablative laser (1540 nm Er:glass, 10 J/cm2 per pulse, three pulses, 2 Hz repetition rate, 4 mm spot, +5 degrees C cooling) and daily topical application of 0.05% retinaldehyde immediately after the first laser treatment and up to 3 months after the fifth treatment. The CTRL group (eight patients) was treated under similar conditions, except with a daily application of excipient. The thickness of the skin (forehead and neck) was measured by ultrasound imaging before the first treatment, 1 month after the third treatment, 1 month after the fifth treatment and 3 months after the fifth treatment.

RESULTS

An increase of dermal thickness was observed for all patients treated by laser (groups RAL and CTRL) on the forehead and neck. However, the increase was greater for the RAL group (retinaldehyde) when compared with the CTRL group (excipient). Three months after the fifth treatment, the increase in dermal thickness (%) was, respectively, 5.27 versus 1.13 for the forehead and 10.54 versus 3.57 for the neck. The difference between groups was statistically significant in favor of the retinaldehyde group for the forehead (p<0.05) and of limited significance for the neck (p=0.08).

CONCLUSION

When considering the reduced number of patients in each group, the statistical analysis demonstrates an evident advantage of using retinaldehyde versus excipient. This study demonstrates that irradiation with a 1540 nm Er:glass laser can be potentiated with concomitant daily topical application of 0.05% retinaldehyde.

The Cardiff Acne Disability Index: Cultural and Linguistic Validation in French

BACKGROUND

The Cardiff Acne Disability Index (CADI) evaluates the impact of acne on the patient's life.

OBJECTIVE

The objective of the present study was to translate the CADI into French and to validate the French version.

METHOD

The CADI was translated into French following international methodological recommendations (translation, quality control, back-translation and pilot test).

RESULTS

Compatibility difficulties between the cultural background of UK and France were identified and resolved by the translation process, which should guarantee that specific words and phrases reflect the cultures in the respective countries. A pilot test in volunteers demonstrated the clarity and understandability of the questions across social classes and ages. A preliminary test-retest comparison of the final scale showed sufficient reliability, with a correlation coefficient of 0.90 for the total CADI score of the French version. Moreover, the good internal consistency of the scale was demonstrated with a Cronbach alpha of 0.87.

CONCLUSION

The CADI, a valuable tool for assessing the impact of acne on a patient's life, can now be used in French.