[Feasibility and reliability of the Spanish version of the Leeds Revised Acne Grading Scale]

Abstract

Background: Although there are more than 25 acne grading systems, there is no consensus on which is most appropriate. Unification of the classifications is recommended in order to facilitate therapeutic decisions.

Objective: To assess the feasibility and reliability of the Spanish version of the Leeds revised acne grading (LRAG) scale in patients with acne vulgaris in Spain.

Patients and methods: We conducted a prospective, multicenter, observational study in Spain, including patients with acne affecting at least 1 of 3 regions: face, back, or chest. Patients were assessed using the LRAG scale and lesion counting. Changes in the scores were determined at 4-6 weeks, and were correlated with the lesion count. Physicians were asked 4 questions regarding difficulty using the scale and the time employed.

Results: A total of 259 sites of acne were assessed in 239 patients at 57 centers. The majority of physicians (89.5%) stated that the LRAG scale was not difficult to use. The mean administration time was 3.12min. Cross-sectional validity (P<.012 for the face, P<.001 for the back and chest), longitudinal validity (P<.0001 for the face, back, and chest), and intraobserver and interobserver reliability (Cronbach α >0.8) were significant for inflammatory lesions in all regions. Sensitivity to change was demonstrated for lesions in all regions, based on the correlation between the difference in severity and the number of lesions recorded by the LRAG, and the difference in the lesion count between baseline and follow-up.

Conclusion: The Spanish version of the LRAG scale is a practical and reliable tool and is sensitive to change. It is a valid tool for the objective assessment of the severity of acne.