Client/Case Management Algorithm for Skin Analysis and Acne

This assignment provides a detailed analysis of a client/case management algorithm for acne, drawing insights from the Leeds Acne Grading System. The algorithm is designed as a decision-making tool for clinicians, presented as an A4-sized pictogram. It includes skincare recommendations (e.g., gentle cleansers with salicylic acid), treatments that can be performed by a Dermal Clinician (e.g., chemical peels, light therapy), and inter-professional management strategies, such as referrals to a beauty therapist or dermatologist. The justification section explains the choice of the Leeds Acne Grading System, highlighting its comprehensiveness, clarity, and clinical recommendations based on extensive clinical trials. The assignment also discusses the grading system's advantages and its multidisciplinary and patient-centered approach, making it an effective tool for acne assessment and management. The document also provides references of the research papers used in the assignment.

Running head: SKIN ANALYSIS
SKIN ANALYSIS
Name of the Student:
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Author note:

1SKIN ANALYSIS
Introduction: Choice of Grading Tool
For the purpose of assessing the severity of acne and formulation of an algorithm of acne
and skin analysis, insights and ideas have been taken from the Leeds Acne Grading System,
published in 1984 and revised again in 1998, by Burke, Cunliffe and Gibson (Kamra & Diwan,
2017).
Justification
Comprehensiveness
A key justification for taking insights from the Leeds Acne Grading is its adoption of a
comprehensive approach for the purpose assessing the rate of severity of acne among patients.
The chosen grading scale not only provides pictures of acne lesions in the face but also in other
areas such as back and chest – that is, in areas which otherwise are difficult to examine and
explain personally by the patient (Dressler, Rosumeck & Nast, 2016). Further, taking insights
from the Leeds Acne Grading System, in addition to merely identification of acne severity in
terms of lesion counting, the algorithm also provides insights on the clinical features, skin care,
treatments and referrals to be recommended for each stage of acne severity. Hence, this is
indicative of a comprehensive approach of acne grading, which goes beyond merely visual
inspection and identification and incorporates holistic recommendations of required actions to be
undertaken. Thus, the ability to provide comprehensive and holistic acne assessment information
forms the underlying rationale for selection of this acne algorithm (Layton, 2014).

2SKIN ANALYSIS
Clarity
A key justification of selection of the chosen acne algorithm using insights from the
Leeds Acne Grading System, is the high level of simplified clarity with which, clinicians as well
as non-clinical individuals like the general public can identified various grades of severity of
acne. The acne algorithm chosen, utilizes a photographic grading system which grades levels of
seriousness of acne stages based on lesion photographs on the face. Pictorial information has
been implicated to result in ease and clarity of understanding as compared to merely written
information, which the chosen acne algorithm has incorporated, by taking insights from the
Leeds Acne Grading System (Clark, Saric & Sivamani, 2018). Further, the Leeds Acne Grading
System, the components of which have been incorporated in the chosen algorithm, utilizes
polarized and fluorescent light photography techniques - a technique advantageous than acne
algorithms using normal color photography due to their ability to highlight acne lesions for
inspections with greater clarity. Hence, the increased clarity and ease of viewing associated with
the chosen acne algorithm justifies its selection (Becker, Wild & Zouboulis, 2017).
Grading System
The chosen acne algorithm, which has been formulated by taking insights from the Leeds
Acne Grading Scale, utilizes a grade counting approach towards acne assessments, which
possesses key advantages over algorithms utilizing lesion counting systems. Acne assessment
scales adopting a grade system of evaluation are advantageous not only because they showcase
the lesions which are dominant but also highlight the extent to which the lesions are severe or
transmitted across the dominant surface (López-Estebaranz, Herranz-Pinto & Dréno, 2017).
Further, the ease, clarity and comprehensive associated with this acne algorithm results in it
being a quick and simple procedure underlying acne screening and diagnosis. Hence, the

3SKIN ANALYSIS
avoidance of time constraints coupled with an assessment of lesion extent are key points
underlying the justification for selection of this acne algorithm (Chiang, Hafeez & Maibach,
2016).
Clinical Recommendations
The Leeds Acne Grading System, which has been used to formulate the chosen acne
algorithm, is widely used in offices, health centers and clinical settings due its ease. Further, the
Leeds Acne Grading System was formulated after approximately 1000 photographs being
extensively evaluated by four assessors of acne and an expert panel of three dermatologists
(Auffret et al., 2016). Further, the photographs so utilized were further assessed for clarity and
relevance by clinicians and authors. Hence, considering that these guidelines prevalent in the
Leeds Acne Grading System and incorporated in this acne algorithm, have been formulated after
extensively clinical trials and widely used by clinical settings - the formulation and selection of
the same is justified (Thappa & Malathi, 2017).
Ease of Understanding
In addition, to incorporation of pictures which have been considered to enhance ease in
understanding, the usage of a table in this acne algorithm, also enhances clarity of
comprehension. Incorporation of information in a table has been known to improve
understanding among individuals from non-clinical backgrounds due to its summarization,
segregation and concise arrangement of data. Hence, the ease with which this acne algorithm can
be understood by individuals irrespective of clinical backgrounds, due to usage of pictures and
tables, justifies its usage (Tuchayi et al., 2015).

4SKIN ANALYSIS
Multidisciplinary and Patient Centered
The chosen ace algorithm not only refers the various health professionals patients can
consult for treatment but also provides information on home-based strategies for acne
management. Indeed, dermal symptoms of acne are also associated with psychological
consequences requiring multidisciplinary treatment, which this algorithm has incorporated
justifying its usage (Cook, Krassas & Huang, 2010). Further, acne can also be managed with
simple home based strategies suited to patient’s comfort and convenience hence requiring patient
centered approaches - incorporated by the chosen acne algorithm (Kumar et al., 2016).

5SKIN ANALYSIS
References
Auffret, N., Claudel, J. P., Leccia, M. T., Poli, F., Farhi, D., & Dréno, B. (2016). AFAST–Adult
Female Acne Scoring Tool: an easy‐to‐use tool for scoring acne in adult females. Journal
of the European Academy of Dermatology and Venereology, 30(5), 824-828.
Becker, M., Wild, T., & Zouboulis, C. C. (2017). Objective assessment of acne. Clinics in
dermatology, 35(2), 147-155.
Chiang, A., Hafeez, F., & Maibach, H. I. (2016). Photography in Acne: Skin Metrics. Measuring
the Skin, 1-13.
Clark, A. K., Saric, S., & Sivamani, R. K. (2018). Acne Scars: How Do We Grade
Them?. American journal of clinical dermatology, 19(2), 139-144.
Cook, D., Krassas, G., & Huang, T. (2010). Acne: best practice management. Australian family
physician, 39(9), 656.
Dressler, C., Rosumeck, S., & Nast, A. (2016). How much do we know about maintaining
treatment response after successful acne therapy? Systematic review on the efficacy and
safety of acne maintenance therapy. Dermatology, 232(3), 371-380.
Kamra, M., & Diwan, A. (2017). Acne: current perspective. Journal of Applied Pharmaceutical
Research, 5(3), 1-7.
Kumar, S., Singh, R., Kaur, S., & Mahajan, B. B. (2016). Psychosocial impact of acne on quality
of life in North India: A hospital-based cross-sectional study. Journal of Pakistan
Association of Dermatology, 26(1), 35-39.

6SKIN ANALYSIS
Layton, A. M. (2014). The Leeds Acne Grading Technique. In Pathogenesis and Treatment of
Acne and Rosacea (pp. 317-324). Springer, Berlin, Heidelberg.
López-Estebaranz, J. L., Herranz-Pinto, P., & Dréno, B. (2017). Consensus-Based Acne
Classification System and Treatment Algorithm for Spain. Actas Dermo-Sifiliográficas
(English Edition), 108(2), 120-131.
Thappa, D. M., & Malathi, M. (2017). Acne Vulgaris Scoring. Agache’s Measuring the Skin, 1-
19.
Tuchayi, S. M., Makrantonaki, E., Ganceviciene, R., Dessinioti, C., Feldman, S. R., &
Zouboulis, C. C. (2015). Acne vulgaris. Nature reviews Disease primers, 1, 15029.