Language disparities between patients and dermatologists in describing acne lesions Michelle Lucero, MD, a Sandra Bendeck, MD, b Frances Ramos-Ceballos, MD, b Jovonne Foster, MS, b and Suephy C. Chen, MD, MS b,c Atlanta, Georgia Background: There are no studies evaluating the comprehension of terms used by dermatologists to describe acne lesions. Objective: The goal is to evaluate the comprehension of terms and pictures representing various acne lesions. Methods: Patients were asked to describe terms and pictures of various acne lesions. Responses were graded as nonspecific, consistent, or inconsistent with physicians’ description of the same lesion. Results: For 5 of 9 terms and for 2 of 6 pictures, the majority of responses were inconsistent or nonspecific. Limitations: Our sample size was limited and did not represent all ethnic groups, educational levels, and geographic regions. We did not record which patients had acne versus which patients did not. Finally, the wording of the question ‘‘What words would you use to describe what you see in the picture?’’ may be misleading. Conclusions: Patients have limited understanding of terminology commonly used by dermatologists to describe acne lesions. ( J Am Acad Dermatol 2007;56:268-73.) E ffective communication between physicians and patients is vital as patients who under- stand their diagnosis and treatment are more likely to be satisfied with their care, 1,2 compliant, 3 and to have better clinical outcomes such as survival and quality of life. 4,5 However, information transfer and development of mutual understanding between physicians and patients are often limited by the use of medical terminology. Numerous studies of patients’ comprehension of medical terms 6-9 used in peptic ulcers, 10 diabetic feet, 11 orthopedics, 12 and cancer 13,14 illustrate the disparity between physicians and patients in the interpretation of terms used in diagnosis, etiology, treatment, and prognosis. 15 These studies not only have important implications for patient care, but also for research. The language disparity between physi- cians and patients must be identified and evaluated if techniques such as self-completion questionnaires are to play a reliable part in clinical research. 6 There are no studies that assess comprehension of dermatologic terminology. Specifically for acne, there currently exist two acne-specific quality of life questionnaires, the Acne-QOL 16 and the Acne Qual- ity of Life Scale (AQLS), 17 which include a patient self- rated acne severity questionnaire. Neither evaluates patient comprehension of terms used to describe acne lesions. The purpose of this study was to evaluate the comprehension of terms and pictures of common acne lesions. We further investigated potential fac- tors behind any lack of comprehension. From Morehouse School of Medicine, a Department of Dermatol- ogy, Emory University, b Department of Health Services Re- search and Development, Division of Dermatology, Atlanta Veterans Affairs Medical Center. c This project was supported in part from an Emory Skin Disease Research Center Pilot and Feasibility grant (No. P30AR42687) from the National Institute on Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health. Dr Chen is supported in part by a Mentored Patient Oriented Career Development Award (No. K23AR02185-01A1) from the National Institute on Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health. Conflicts of interest: None identified. Reprint requests: Suephy C. Chen, MD, MS, Assistant Professor, 101 Woodruff Circle, Atlanta, GA 30322. E-mail: schen2@emory.edu. Published online December 12, 2006. 0190-9622/$32.00 ª 2007 by the American Academy of Dermatology, Inc. doi:10.1016/j.jaad.2006.09.024 268