Systemic inflammation and associated factors in truncal versus facial acne in young adults: an analytical cross-sectional study

Abstract

   Background: Acne is a common skin condition in young adults. It affects appearance, psychological well-being, and overall health. Recently, a paradigm shift has suggested that acne is not merely a localized follicular disorder but may be significantly driven by systemic inflammation. Evidence is growing that truncal acne is linked to systemic inflammation and lipid metabolism disorders; however, the specific link between systemic inflammatory markers, metabolic features, and the distribution of acne lesions (truncal versus facial) remains underexplored.
   Methods: An analytical cross-sectional descriptive study was conducted on 75 patients diagnosed with acne who received treatment at Ho Chi Minh City Dermatology Hospital in June 2025. Patients were divided into two groups: a facial acne group (n = 40) and a truncal acne group (n = 35). Anthropometry, lifestyle, and skin care habits were collected via a questionnaire. Blood test results were obtained through laboratory software.
   Results: A study of 75 patients (mean age 18.2 ± 3.5, with 81.3% being students) found that 100% of cases of truncal acne were accompanied by lesions on the face, with the back being the most common site on the trunk. The group of patients with truncal acne had a significantly higher BMI (22.6 ± 3.9), was more common in males (OR = 4.64, 95% CI: 1.74 – 12.37, p = 0.002), had an earlier age of onset (mean = 14; OR = 0.76, 95% CI: 0.61 – 0.93, p = 0.009), and had a longer duration of illness compared to the group with facial acne only. In terms of laboratory findings, truncal acne was associated with elevated NLR and PLR; each unit increase in NLR was associated with a 5.45 higher odds of truncal acne (95% CI: 1.80 – 18.7, p = 0.003), alongside increased total cholesterol levels and reduced HDL-C (OR = 0.13, 95% CI: 0.02 – 0.91, p = 0.04).
   Conclusions: Truncal acne accounts for 46.7% of acne patients, characterized by a broader distribution pattern (present in 100% of cases) and primarily affects the back. Clinically, the condition is most commonly seen in males with a high BMI, has an early onset (average age of 14), and a prolonged course. Biologically, the condition is characterized by systemic inflammation (elevated NLR) and dyslipidemia (elevated total cholesterol, reduced HDL cholesterol).

DOI: 10.59715/pntjmp.5.2.15