Cardiff Acne Disability Index in Sarawak, Malaysia

Background: Acne is considered a cosmetic nuisance in Malaysia since no insurance coverage is provided for its treatment. Its psychological impact is unknown. Objective: The aim of this study is to determine the impact of acne on quality of life and its relationship with severity. Methods: A cross-sectional study using the Cardiff acne disability index (CADI) and Global Acne Grading System for acne severity grading was done in three government-run dermatology clinics in Sarawak, Malaysia. Results: The study cohort of 200 patients had a mean CADI score of 5.1. Most of the patients (59.5%) had mild CADI impairment, with the domain of feelings most affected. Patients with a family income <1,000 United States Dollor/month had a higher mean CADI (mean 5.5 vs. 4.4; p=0.04). Females, indigenous groups, and patients with tertiary education tended to have more severe CADI impairment (p > 0.05). The correlation between CADI and mild acne severity was low (Pearson correlation coefficient=0.35; p < 0.001) but became insignificant for moderate and severe acne. Conclusion: Acne impairment in Sarawak was moderate and must be addressed. It should be viewed as a psychologically disabling disease requiring optimal management and resource allocation. (Ann Dermatol 24(2) 158 similar to 161, 2012)