{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:36:15Z","timestamp":1790444175314,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acne vulgaris varies in clinical severity, from minimal comedonal disease to severe hemorrhagic and ulcerative lesions with scarring. While a family history confers a higher risk for developing acne, the correlation between heritability and clinical severity remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the natural history and heritability of severe acne with scarring in patients undergoing isotretinoin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 101 subjects with severe acne with scarring and its variants, including acne conglobata and acne fulminans, were enrolled. All subjects and adult family members underwent an interview regarding their acne, and a corresponding \u201chistorical\u201d Investigator's Global Assessment (hIGA) score (0\u00a0=\u00a0clear, 1\u00a0=\u00a0almost clear, 2\u00a0=\u00a0mild, 3\u00a0=\u00a0moderate, 4\u00a0=\u00a0severe, 5\u00a0=\u00a0very severe) was assigned. Study assessors performed an \u201cexamination\u201d Investigator's Global Assessment (eIGA) based on the clinical examination of each subject (0\u00a0=\u00a0clear, 1\u00a0=\u00a0almost clear, 2\u00a0=\u00a0mild, 3\u00a0=\u00a0moderate, 4\u00a0=\u00a0severe, 5\u00a0=\u00a0very severe). A detailed family history and pedigree were documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most subjects were Caucasian (44.5%) and male (79.2%) who had previously used doxycycline and\/or minocycline (86.1%). The mean eIGA and hIGA scores were 2.7 and 4.4, respectively. 37.2% of subjects had one first\u2010degree relative with a history of moderate or severe acne with scarring; of note, of the patients with hemorrhagic disease, 30% had at least one parent with moderate or severe acne.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Severe forms of acne often \u201ccluster\u201d in families, underscoring the heritable nature of acne and the prognostic value of a family history of moderate or severe disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.14990","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T23:15:03Z","timestamp":1652915703000},"page":"535-540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Severe acne and its variants: Exploring its natural history and heritability"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0273-5241","authenticated-orcid":false,"given":"Tanya","family":"Greywal","sequence":"first","affiliation":[{"name":"Division of Dermatology University of Washington  Seattle Washington USA"},{"name":"Division of Pediatric and Adolescent Dermatology Rady Children's Hospital San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayan","family":"Kusari","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M.","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Adolescent Dermatology Rady Children's Hospital San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5692-1990","authenticated-orcid":false,"given":"Jenna","family":"Borok","sequence":"additional","affiliation":[{"name":"Division of Dermatology Albert Einstein College of Medicine  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Proudfoot","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research Institute University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3911-9813","authenticated-orcid":false,"given":"Jusleen","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"Insight Dermatology  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila Fallon","family":"Friedlander","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Adolescent Dermatology Rady Children's Hospital San Diego  San Diego California USA"},{"name":"Scripps Health Dermatology  San Diego California 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