Acne is most common in adolescents aged 12-18 years and more severe in males. The major factors involved in acne pathogenesis are increased sebum production stimulated by androgens, proliferation of the bacteria Propionibacterium acnes in hair follicles, altered keratinization of follicles, and inflammation. Treatment involves topical and oral antibiotics, retinoids, and isotretinoin for severe acne. Dietary factors like high glycemic load and sugar intake may influence acne, but evidence is limited. Acne is graded based on the number and type of lesions present.
Chemical peels are used to improve and smooth the texture of skin by removing the outermost layer of skin.They can reduce freckles, age spots, dark patches and can give you a nourished and healthy skin.
Various peels can be used according to your requirements like glycolic acid, salicylic acid, lactic acid or carbolic acid.You will need to avoid sun for around 1 month and a little swelling might occur post treatment.They are ideal treatments for people with fair skin but shows good results even in people with dark skin.
Chemical peeling is done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Melasma| Melasma and its Treatment| Facial Pigmentation| Post-Pregnancy Pigm...Dr. Rajat Sachdeva
Melasma, Pigmentation on facial skin, most commonly occur on the face of female and in Dark Skin Races.
Treatment for melasma, Sun protection, avoid waxing, Tretinoin, Hydroquinone, Corticosteroid, Azeloic Acid, Glycolic Acid, Chemical Peels, Microdermabrasion, Laser Intensed Pulse Light,
This is a seminar conducted by 4th year medical student under supervision of a lecturer. Sorry for not attaching the references.
Information were from few textbooks, google and also from previous dermatology posting group's seminar.
Rosacea is a chronic (long-term) disease
that affects the skin and sometimes the eyes. The disorder is characterized by
redness, pimples, and, in advanced stages, thickened skin. Rosacea usually
affects the face. Skin on other parts of the upper body is only rarely
involved.
Skin cancer is a common, usually low-grade cancerous (malignant) growth of the skin. It starts from cells that begin as normal skin cells and transform into those with the potential to reproduce in an out-of-control manner. Unlike other cancers, the vast majority of skin cancers have no potential to spread to other parts of the body (metastasize) and threaten your life.
Chemical peels are used to improve and smooth the texture of skin by removing the outermost layer of skin.They can reduce freckles, age spots, dark patches and can give you a nourished and healthy skin.
Various peels can be used according to your requirements like glycolic acid, salicylic acid, lactic acid or carbolic acid.You will need to avoid sun for around 1 month and a little swelling might occur post treatment.They are ideal treatments for people with fair skin but shows good results even in people with dark skin.
Chemical peeling is done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
Melasma| Melasma and its Treatment| Facial Pigmentation| Post-Pregnancy Pigm...Dr. Rajat Sachdeva
Melasma, Pigmentation on facial skin, most commonly occur on the face of female and in Dark Skin Races.
Treatment for melasma, Sun protection, avoid waxing, Tretinoin, Hydroquinone, Corticosteroid, Azeloic Acid, Glycolic Acid, Chemical Peels, Microdermabrasion, Laser Intensed Pulse Light,
This is a seminar conducted by 4th year medical student under supervision of a lecturer. Sorry for not attaching the references.
Information were from few textbooks, google and also from previous dermatology posting group's seminar.
Rosacea is a chronic (long-term) disease
that affects the skin and sometimes the eyes. The disorder is characterized by
redness, pimples, and, in advanced stages, thickened skin. Rosacea usually
affects the face. Skin on other parts of the upper body is only rarely
involved.
Skin cancer is a common, usually low-grade cancerous (malignant) growth of the skin. It starts from cells that begin as normal skin cells and transform into those with the potential to reproduce in an out-of-control manner. Unlike other cancers, the vast majority of skin cancers have no potential to spread to other parts of the body (metastasize) and threaten your life.
history of TB,epidemiology, clinical features, lab diagnosis, treatment, MDR TB, XDR TB, TDR TB, and mechanism of drug resistant, methods of identification of resistant drugs
Acne is the result of overactive sebaceous glands and excessive keratin production, leading to excessively oily skin that is prone to blackheads and pimples. You cannot change your skin type you cannot stop this process permanently. However, you can control this process and minimise your acne breakout reoccurrence by....
hanifin and rajka criteria, entymology, definition of AD, atopy, etiopathogenesis of AD, genetics in AD, filaggrin, epidermal barrier dysfunction, atopic march, hygiene hypothesis, infantile phase of AD, childhood phase of AD, adult phase of AD, pityriasis alba, denne morgan folds, dirty neck appearence, nipple dermatitis, hanifin and rajka criteria, UK refinement of hanifin and rajka criteria, millenium criteria of AD, japanese dermatological association criteria, management of AD, wet wrap therapy,
Management of Hyper-Androgenism: MADE EASY-Life Care Centre_Dr.Sharda JainLifecare Centre
Management of Hyper-Androgenism: MADE EASY
Dr.Sharda Jain
Life Care Centre
-ACNE
-Virilization
-Hirsuitism
-PCOD
-Combined Oral Pills
-Polycystic Ovary Syndrome
-Congenital Adrenal Hyperplasmia
pruritus/itching of pregnancy , its epidemiology , types and pathogenesis along with management .
References are from fitzpatrick synopsis of dermatology & other sources ( references kept along with slide)
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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2 Case Reports of Gastric Ultrasound
2. Some facts abut acne
1. peak age 12 to 18 yo
2. more severe in males
3. most common affected sites face → truncal
3. CPG
to provide an evidencebased
guidance for primary care physicians
and other healthcare providers
to identify the appropriate management
of acne.
CPG
4. Pathogenesis
**** multifactorial.
Acne vulgaris can be divided into noninflammatory
(open and closed comedones) and inflammatory (papules, pustules
and nodules) lesions.
The most important factors involved are:
a. Increased sebum production
b. Propionibacterium acnes proliferation
c. Altered follicular keratinisation
d. Inflammation
5. 1) INCREASED SEBUM
PRODUCTION
Androgen Mediated Sebum Production
- overstimulation of the gland by high levels androgens or by hypersensitivity of
normal levels androgens
- regulate genes responsible for sebaceous gland growth and sebum production.
-The pilosebaceous unit possesses the steroid metabolising enzymes
that convert DHEAS to testosterone and DHT.
- Testosterone is also converted to the more potent androgen i.e. DHT by the enzyme
5α-reductase.
7. proliferation of these bacteria
is responsible for the
initiation of inflammation.
inflammatory response
to the bacterium
and these metabolic by
products
leads to the formation of
papules, pustules, and nodules
8.
9. c) Altered Follicular Keratinisation
- In patients with acne, the rate of keratinocyte desquamation at the
follicular infundibulum is altered.
- The keratinocytes accumulate and become interwoven with
monofilaments and lipid droplets
- This accumulation of cells and sebum results in the formation of
microcomedones (the microscopic precursor to all acne lesions)
- There is also the presence of 5α-reductase activity in the
infrainfundibular segments of sebaceous
follicles which increases androgen production and subsequent follicular
hyperkeratosis
10.
11. D) Inflammation
- Cellular products from P. acnes stimulate the recruitment of CD4
,lymphocytes and subsequently neutrophils
- These inflammatory cells penetrate the follicular wall,
causing disruption of the follicular barrier.
- This leads to the release of lipids, shed keratinocytes and P. acnes
into the surrounding dermis, inciting further recruitment of
inflammatory cytokines and neuropeptides including substance
**Linoleic acid has also been found to regulate IL-8 secretion and
reduce the inflammatory reaction
**Hence, deficiency of linoleic acid may
increase hyperkeratinisation of the epidermis.
12. Risk and aggravating factors
Risk factors Aggravating factors
A significant positive family history of acne
has been demonstrated
especially when acne is found in:
• twins (p<0.0001)21, level III
• mother (OR=2.8, 95% CI 1.8 - 4.5)22, level III
• first degree relative [(OR=4.0, 95% CI 3.4-4.7) 23, level II-2 and
(OR=3.9, 95% CI 2.7 - 5.5)24, level II-2]
• multiple family members (p<0.0005)22,
Smoking [(OR for male smokers=2.3, 95% CI 1.4 - 3.8)26, level III and (OR
for active smokers=2.0, 95% CI 1.4 - 2.9)27, level III]
• A dose dependent relationship has also been shown (p=0.001).
27, level III However, another study does not support this finding.28, level III
ii. A significant association between obesity
and acne in children
(p<0.001)25, level III
ii. Stress [(r=0.23, p=0.029)29, level II-2 and (r=0.61, p<0.01)30, level II-2]
There is no retrievable evidence regarding gender as a risk factor for acne. Facial therapy or salon facial massage.31, level III
13. Role of diet and supplements
1) Low glycemic diet :
- The glycaemic load (GL) concept describes the quality (the glycaemic index
[GI] of the food) and quantity (the amount) of carbohydrate in a meal or diet.
- The GL of a typical serving of food is the product of the amount of available
carbohydrate in that serving and the GI of the food.
-In general, most refined carbohydrate devoid of fibre is high in GI while intact
carbohydrate
(whole grains products), legumes, milk (and milk products), fruits and
vegetables are low GI foods.
iii. Sugar, Fibre and Fat
There is no acne occurrence among two non-western communities
(Kavitan in Papua New Guinea and Ache in Paraguay) who consume
non-western diet consisting of high fibre and low fat content with
negligible added sugars.38, level III
iv. Chocolate, Oily Foods and Nuts
There is no good evidence for oily foods in the pathogenesis of acne.
In a local study, no significant differences were found in the frequency
of chocolate and nuts
14. Dietary Supplements
There is no conclusive statement on the effectiveness of zinc supplement in
acne.39, level lll In addition, there is no retrievable evidence on the efficacy of
vitamin
A, vitamin C, vitamin E and omega-3 fatty acids in the management of acne.
15. Treatment
1.. pharmacological
Induction therapy
• Maintenance therapy
- antibiotic – resistance ( eg : clinda, erythromycin,
2. Non pharacological :
physical therapy such as laser, phototherapy, chemical peels and comedone extraction.
However, these are not the mainstay of acne treatment.
The aims of acne management are:-
• to induce clearance of lesions
• to maintain remission and prevent relapse
• to prevent physical and psychological complications
16. Topical treatment
Topical therapy is the mainstay of treatment for mild acne. It is also useful for
moderate acne where comedones are predominant. It plays an important role in
induction of remission and maintenance phases of the treatment.
Practical tips on topical agents
• Apply a thin layer to the entire susceptible areas
• Topical retinoids are to be avoided during pregnancy.
• Topical azelaic acid may be useful in acne patients with hyperpigmentation
• Topical antibiotics should not be used as monotherapy to minimise
antibiotic resistance
17. Recommendations (topical)
•Topical benzoyl peroxide, topical retinoid, topical antibiotics, topical
azelaic acid or topical salicylic acid are indicated for mild to moderate
acne. (Grade A)
• Topical sulfur combinations can be used in for mild to moderate acne.
(Grade C)
• Benzoyl peroxide should be initiated at a concentration of 2.5% or 5%.
(Grade A)
• Topical fixed combination such as clindamycin and benzoyl peroxide
or adapalene and benzoyl peroxide can be used as an option for the
treatment of mild to moderate acne. (Grade A)
18. Recommendations ( systemic)
Practical tips on oral antibiotics
• Oral tetracycline, doxycycline, minocycline or co-trimoxazole are
contraindicated in pregnancy.
• Sulfonamide antibiotics have been reported to cause severe adverse
drug reactions such as Stevens-Johnson syndrome and toxic epidermal
necrolysis.
• Oral antibiotics should not be prescribed continuously for more than six
Months
Recommendation
• Oral tetracycline, oral doxycycline, oral erythromycin or oral minocycline may
be used as treatment for moderate to severe acne. (Grade A).
19. Acne Grading
Table 3: Comprehensive Acne Severity Scale (CASS)
GRADE* DESCRIPTION
Clear 0
No lesions to barely noticeable ones. Very few
scattered comedones and papules.
Almost clear 1
Hardly visible from 2.5 metre away. A few scattered
comedones, few small papules and very few pustules.
Mild 2
Easily recognisable; less than half of the affected area
is involved. Many comedones, papules and pustules.
Moderate 3
More than half of the affected area is involved.
Numerous comedones, papules and pustules.
Severe 4
Entire area is involved. Covered with comedones,
numerous pustules and papules, a few nodules and cyst.
Very severe 5
Highly inflammatory acne covering the affected area,
with nodules and cyst present.
Recommendation
• Comprehensive Acne Severity Scale (CASS) may be used for grading of
acne severity in clinical practice. (Grade C)
*These guidelines recommend using the CASS for grading of acne severity in clinical
practice.