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Our Dermatol Online. 2014; 5(4): 352
Date of submission:  16.09.2014 / acceptance: 20.09.2014
Conflicts of interest: None

Hayder R. Al-Hamamy, Khalifa E. Sharquie, Adil A. Noaimi, Wajeeh N. Hussein


Ass. Prof. Antonio Chuh MD FRCP FRCPCH1, Prof. Vijay Zawar MD DNB DV&D FAAD2

1School of Public Health, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
2Department of Dermatology, Godavari Foundation Medical College and Research Center, DUPMCJ, India
How to cite this article: Chuh A, Zawar V. Comment: Topical erythromycin-zinc acetate complex lotion versus topical erythromycin gel in treatment of mild to moderate acne vulgaris . Our Dermatol Online. 2014; 5(4): 352.

Hayder et al [1] described a well-conducted clinical trial comparing topical erythromycin-Zinc acetate complex lotion against topical erythromycin get in treating patients with acne vulgaris of mild to moderate severity. This study bears several limitations, such as its being single-blinded, a predetermined recruitment period not clearly delineated, the response rate and completion rate unclear, and the randomisation process, if any, not being explicit. However, the authors courageously admitted some of these limitations. We agree that their analyses and conclusions are largely valid, statistically significant, and clinically pertinent. We have previously conducted studies on similar groups of patients with acne of mild to moderate severity [2,3]. At that time, we found that equipments on patient-assessed outcomes were readily available [4,5], and validly translated several instruments [6,7]. With such instruments, we have been able to determine how patients judged their clinical response to different treatment modalities. We could also quantitatively evaluate how different treatments for acne can exert different impacts on the quality of life to patients, and which of the many aspects of such including their self image, their moods, their activities of daily living, adverse impacts of treatments, and effects on their social activities. We thus advise future investigators on acne vulgaris to consider the inclusion of patient-assessed data as primary outcome variables. We would highly recommend, a qualitative branch in such clinical trials, so that the novel and original opinions from the patients would be realised and analysed in depth. After all, patients are the bosses in the enterprise which we call clinical medicine.
1. Hayder R Al-Hamamy, Khalifa E Sharquie, Adil A Noaimi, Wajeeh N Hussein. Topical erythromycin-Zinc acetate complex lotion versus topical erythromycin gel in treatment of mild to moderate acne vulgaris. Our Dermatol Online. 2014;5:347-51.
2. Law MP, Chuh AA, Molinari N, Lee A. An investigation of the association between diet and occurrence of acne: a rational approach from a traditional Chinese medicine perspective. Clin Exp Dermatol. 2010;35:31-5.
3. Chuh AA, Zawar V, Wong WC, Lee A. The association of smoking and acne in men in Hong Kong and in India: a retrospective case-control study in primary care settings. Clin Exp Dermatol. 2004;29:597-9.
4. Motley RJ, Finlay AY. Practical use of a disability index in the routine management of acne. Clin Exp Dermatol. 1992;17:1-3.
5. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) – a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210-6.
6. Law MP, Chuh AA, Lee A. Validation of a Chinese version of the Cardiff Acne Disability Index. Hong Kong Med J. 2009;15:12-7.
7. Chuh AA, Chan HH. Effect on quality of life in patients with pityriasis rosea: is it associated with rash severity? Int J Dermatol. 2005;44:372-7.

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