{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:36:36Z","timestamp":1783488996479,"version":"3.55.0"},"reference-count":9,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:00:00Z","timestamp":1715126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010654","name":"Universidad San Francisco de Quito","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010654","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acne is a common disease that is associated with scarring and substantial psychosocial burden. The Global Burden of Skin Disease reported that the burden from acne as measured by disability-adjusted life years (DALYs) from 188 countries and specifically that it is greatest in Western Europe, high-income North America and Southern Latin America. This paper aimed to identify risk factors for acne scarring specific to the Ecuadorian population in order to adapt the 4-ASRAT tool accordingly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational prospective study. Participants were recruited to complete a survey that was developed based on the potential risk factors for acne scarring and had facial photographs taken. To determine risk factors and their respective weighting, a logistic regression was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 404 participants. Results from univariate analyses indicated that being male (OR = 2.76 95%CI [1.72; 4.43]), having severe or very severe acne scarring (OR = 4.28 95%CI [1.24; 14.79]), acne duration over 1 year (OR = 1.71 95%CI [1.12; 2.60]), oily skin (OR = 2.02 95%CI [1.27; 3.22]) and the presence of acne on the neck (OR = 2.26 95%CI [1.30; 3.92]), were all significantly associated with the presence of acne scarring. Male sex (2.56 95%CI [1.58;4.17]), oily skin (1.96 95%CI [1.20;3.20]) and severe or very severe acne (3.75 95%CI [1.05;13.37]) remained significant risk factors for acne scarring in the multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>By identifying acne scarring risk factors and applying the tool in everyday dermatology visits, we can reduce the physical and psychological burden that acne scarring causes in the adolescent and adult populations. Further research should be conducted to reassess potential risk factors and complete the adaptation of the tool for the Ecuadorian population, with a larger and more representative study population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0285648","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T13:35:48Z","timestamp":1715175348000},"page":"e0285648","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for acne scarring in Ecuador"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9618-4144","authenticated-orcid":true,"given":"Mikaela","family":"Camacho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Viteri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Yepez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Estrella","family":"Porter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0589-6614","authenticated-orcid":true,"given":"Drifa","family":"Belhadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5077-2621","authenticated-orcid":true,"given":"Caroline","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Guillemot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"issue":"8","key":"pone.0285648.ref001","first-page":"475","article-title":"Acne Vulgaris: Diagnosis and Treatment","volume":"100","author":"L. K. Oge\u2019","year":"2019","journal-title":"American Family Physician"},{"issue":"5754","key":"pone.0285648.ref002","first-page":"29","article-title":"Systematic review of the epidemiology of acne vulgaris","volume":"10","author":"Anna H. Sing","year":"2020","journal-title":"Scientific Reports"},{"issue":"2","key":"pone.0285648.ref003","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/bjd.19477","article-title":"Reviewing the global burden of acne: How could we improve care to reduce the burden?*","volume":"184","author":"A. M. Layton","year":"2021","journal-title":"British Journal of Dermatology"},{"key":"pone.0285648.ref004","article-title":"Prevalence and Risk Factors of Acne Scarring Among Patients Consulting Dermatologists in the USA","author":"Jerry Tan","year":"2017","journal-title":"JDDonline\u2014Journal of Drugs in Dermatology"},{"issue":"Supplement 2","key":"pone.0285648.ref005","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1542\/peds.2019-2056L","article-title":"Current Issues in the Treatment of Acne Vulgaris","volume":"145","author":"K. A. Habeshian","year":"2020","journal-title":"Pediatrics"},{"issue":"4","key":"pone.0285648.ref006","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s40257-018-0358-5","article-title":"Acne Scarring Management: Systematic Review and Evaluation of the Evidence","volume":"19","author":"S. Bhargava","year":"2018","journal-title":"American Journal of Clinical Dermatology"},{"issue":"9","key":"pone.0285648.ref007","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1111\/jdv.14325","article-title":"Development of an atrophic acne scar risk assessment tool","volume":"31","author":"J. Tan","year":"2017","journal-title":"Journal of the European Academy of Dermatology and VenereologyJEADV"},{"key":"pone.0285648.ref008","doi-asserted-by":"crossref","first-page":"651","DOI":"10.12688\/f1000research.23737.1","article-title":"Pilot study for the evaluation and adaptation of a Four Item-Acne-Scar Risk Assessment Tool (4-ASRAT): A resource to estimate the risk of acne-induced scars","volume":"9","author":"J. Estrella Porter","year":"2020","journal-title":"F1000Research"},{"issue":"5","key":"pone.0285648.ref009","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.jclinepi.2004.06.017","article-title":"Substantial effective sample sizes were required for external validation studies of predictive logistic regression models","volume":"58","year":"2005","journal-title":"Journal of clinical epidemiology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0285648","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T13:35:57Z","timestamp":1715175357000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0285648"}},"subtitle":[],"editor":[{"given":"Ahmad Khalid","family":"Aalemi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,8]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0285648","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2023.05.03.23289452","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,8]]}}}