Clinical characteristics and some factors related to common acnes in some hospitals In Ha Noi

Journal of military pharmaco-medicine n 0 1-2020 197 CLINICAL CHARACTERISTICS AND SOME FACTORS RELATED TO COMMON ACNES IN SOME HOSPITALS IN HANOI Tran Dang Quyet1; Vu Van Tien1; Nguyen Thi Hong Hanh1 SUMMARY Objectives: To survey clinical characteristics, some factors related to common acne in some hospitals in Hanoi. Subjects and methods: Research, cross-sectional description, convenient sample size. Results and conclusion: The difference between male and female rates was not statistically significant (above, below 50%). The majority of patients were under 24 years old (85%). Age of onset was mainly under 19 (72.9%). Most people had the disease duration of more than 2 years (60%). Most had parents, siblings with acne (74.7%). The majority of patients were students (73.6%). The vast majority of patients lived in cities (87.6%). The acne was worse in summer than in winter (43.5% and 15.9%). More than half of patients were associated with stress (56.3%). Most were related to sweet, spicy, hot foods, stimulants like coffee and alcohol (83%). The majority was not associated with smoking (85.1%). 100% of patients had lesions such as comedones, papules, pustules. Most had post-inflammatory hyperpigmentations (80%). Other types of lesions had low rates (pitted scar 30%, nodule 22.8%, telangiectasia 20%). 100% of patients had lesions on their face, nearly 50% on the back, nearly 25% on the chest. Majority had lesions on the cheeks (95%), forehead (73%) and on the nose (100%). The mild level was only 7.5%, the rest were medium and heavy.100% of patients had oil skin. The functional symptoms only accounted for 20% (itching and soreness). * Keywords: Common acnes; Clinical characteristics. INTRODUCTION Acne is common skin disease in adolescents, is an inflammation of the hair follicle system, characterized by seborrhea, comedones formation, papules, pustules, cysts, in some cases often accompanied by scars. Pathogenesis mechanisms are often complex and not fully understood. It is thought that there are 4 main factors in the pathogenesis mechanism: hyperkeratosis of hair follicle, increasing sebum secretion, the role of P. acnes bacterium and the inflammatory response. Clinical manifestations of acnes are diverse. The treatment also varied depending on clinical form. To prepare the treatment of acnes effectively, we conducted the project: To survey clinical characteristics, factors related to common acnes in some hospitals in Hanoi (103 Military Hospital, 108 Military Central Hospital, Hanoi Dermatology Hospital) in 2017, 2018, 2019. 1. 103 Military Hospital Corresponding author: Tran Dang Quyet (Tranquyetdalieu@gmail.com)) Date received: Date accepted: 7/1/2020 Journal of military pharmaco-medicine n 0 1-2020 198 SUBJECTS AND METHODS 1. Subjects. Patients with common acnes visited some hospital in Hanoi (103 Military Hospital, 108 Military Central Hospital, Hanoi Dermatology Hospital) from 8 - 2017 to 3 - 2019. 2. Methods. Prospective, cross-sectional description, convenient sample size. * Steps taken: Medical examination, research medical records follow a uniform form. Data processing according to statistical algorithms. RESULTS AND DISCUSSION 1. Number of factors associated with common acnes. Table 1: Gender and age of the patients. Gender (n = 825) Male 407 49.3% Female 418 50.7% p > 0.05 Age (n = 825) 15 - 19 290 35.2% 20 - 24 414 50.2% 25 - 29 52 6.3% ≥ 30 69 8.4% p < 0.05 The incidence of acnes between male and female was not statistically significant. The proportion of patients under 24 years old (85.4%) was much higher than the patients over 24 years old (14.7%), the difference was statistically significant. Our research results were in line with Nguyen Canh Cau’s and Nguyen Khac Vien’s findings [1]. Table 2: The characteristics of patient’s occupation, residence and family history. Patient’s occupation (n = 825) Students 607 73.6% Officers 82 9.93% Others 136 16.47% p < 0.05 Patient’s residence (n = 825) Cities 723 87.6% Countryside 102 12.4% p < 0.05 Family history (n = 825) One parent has acne 351 42.5% Siblings has acne 266 32.2% No family history of acne 208 25.3% p < 0.05 The percentage of patients being students (73.6%) was much higher than that of patients being civil servants and other professions, the difference was statistically significant. The proportion of patients living in cities (87.6%) was much higher than patients living in rural areas, the difference was statistically significant. The proportion of patients with a family history of parents, siblings with acne (74.7%) was much higher than patients without a family history of acne (25.3%), the difference was statistically significant. Our research results were consistent with Bakry O.A and Stephan H’s studies [5], so that acne is a family disease. Journal of military pharmaco-medicine n 0 1-2020 199 Table 3: Age of onset of disease, age of disease. Age of onset of disease (n = 825) 15 - 19 years 602 72.9% 20 - 24 years 116 14% 25 - 29 years 73 8.8% ≥ 30 years 34 4.3% p < 0.05 Age of disease (n = 825) < 1 year 68 8.2% 1 - 2 years 262 31.8% > 2 years 495 60% p < 0.05 72.9% of patients had onset of acne at the age of 15 - 19. This result was consistent with many domestic and foreign studies. This is the age of strong hormonal changes. Patients with more than 2 years of acne accounted for 60%, indicating that acne is a chronic disease. * Distribution of the disease by season of the year: The acne usually appeared in summer (359 patients = 43.5%) rather than in the winter (131 patients = 15.9%), p < 0.05. However, 40.6% of patients (335 patients) were not related to the season of the year. Wolff K’s findings: 71.7% of acne were unrelated to the season [4]. Table 4: Relationship between acne and stress, diet and smoking. Associated with stress (n = 825) Yes 464 56.3% No 361 43.7% p > 0.05 Related to the diet (n = 825) Yes 685 83% No 140 17% p < 0.05 Related with smoking (n = 825) Yes 123 14.9% No 702 85.1% p < 0.05 According to Zian Z [2], up to 68.5% of acne patients were associated with stress, our rate was lower (56.3%), but it also accounted for more than half of patients. Our research results showed that 83% of acne patients were associated with a diet that was high in sweetness, fat, and strong spices (too spicy, too sour), which was suitable for many authors’ findings in the world like Arnol H.L et al [5]. 2. Clinical characteristics of acne vulgaris . * Features of the type of lesions, functional symptoms: Comedones: 825 patients (100%); papules: 825 patients (100%); pustules: 825 patients (100%); hyperpigmentation: 660 patients (80%); pitted scar: 248 patients (30%); nodules: 188 patients (22,8%); telangiectasia: 165 patients (20%); keloids: 82 patients (10%). Our research results were consistent with many domestic and foreign studies such as Dang Van Em [1], Gang L, Yanyang P [3]. Table 5: Characteristics of lesion position Lesion position (n = 825) Face 825 100% Back 398 48.2% Chest 202 24.5% Others 138 16.7% p < 0.05 Lesion distribution on the face (n = 825) Cheeks 784 95% Forehead 605 73.3% Chin 233 28.3% Nose 825 100% Jaw angle 124 15% p < 0.05 Journal of military pharmaco-medicine n 0 1-2020 200 As acne occured in areas of the skin where there were many sebaceous and sebaceous gland active, the lesions appeared more on the face, upper back and chest. On the face, the sebaceous gland was more active in the cheeks, forehead, nose. Our research results were in line with the pathogenesis of acne [1, 2]. Table 6: Disease level, associated with oily skin. Disease level (n = 825) Mild degree 61 7,5% Moderate degree 602 72.9% Severe degree 162 19.6% p < 0.05 Associated with oily skin (n = 825) Oily skin less 371 45% Oily skin much 454 55% p > 0.05 The rate of moderate acne was the highest (72.9%), the rate of mild acne was only 7.5%, because the patients with a mild level rarely went to the doctor, moreover the mild acne can cure itself. Our research results were consistent with Arnol H.L et al [5]. CONCLUSION Through 825 common individual acne patients visiting at some hospitals in Hanoi area, we had the following conclusions: * The number of factors was associated with common acne: - The difference in the percentage of men and women was not statistically significant (approximately 50% or less). The majority of patient was under 24 years of age (85%). Age onset mainly under 19 years old. The majority of patients had the disease duration of more than 2 years. - Most patients had parents or siblings suffering from acne. The majority of patients were students. They mostly lived in cities (87.6%). - More sick in the summer than in the winter. More than half of patients were associated with stress. Most of them were associated with sweet, spicy food, stimulants like coffee and alcohol. The majority were not associated with smoking. * Clinical characteristics of common acne: - 100% of patients with lesion were comedones, papules, pustules. Most of them had hyperpigmentation. Other types of lesion accounted for a low rate. - 100% of patients had lesion on the face, nearly 50% had lesion on the back. Lesion on the chest only accounted for nearly 25%. In the face: the majority had lesions on the cheeks, forehead, 100% had lesion on the nose. - Mild level accounted for only 7.5%, the rest were medium and severe level. 100% of patients had oily skin. Functional symptoms only accounted for 20% (itching and pain). REFERENCES 1. Nguyen Canh Cau, Nguyen Khac Vien. Oily skin and acnes. Dermatology, Graduate Curriculum. People’s Army Publishing House. 2018. 2. Jian Z. Investigation and analysis on the prevalence of acne and the psychological status of the patients with acne. J Yichun Coll. 2011, 33, pp.89-90. 3. Gang L, Yanyang P, R.G. Analysis of performance characteristics of acne vulgaris and severity related factors. J Basic Chin Med. 2015, 21, pp.81-85. 4. Wolff K. Acne vulgaris and acnetiform eruption. Fitzpatrick’s Dermatology in General Medicine. 2008. pp.690-704. 5. Arnold H.L et al. Acne disease of skin. WB. Saunders Company. 1990, pp.250-267.