The Impact of COVID-19 Pandemic on Acne Patients and Their Management: An Observational Multicenter Study from Italy

Round 1

Reviewer 1 Report

During the COVID-19 pandemic, disruptions in daily routines significantly influenced the progression of acne vulgaris, particularly among specific populations like adolescents. This study aims to investigate the psychological impact and its relationship with the progression of acne vulgaris during the pandemic. Conducted in five dermatology clinics in Italy, this observational, multicenter study used remote telephone interviews and approved questionnaires to collect data from 178 acne vulgaris patients undergoing various systemic or topical treatments. The findings revealed a potential correlation between heightened levels of anxiety, depression, stress, and low resilience with the exacerbation of acne symptoms. Additionally, a notable portion of the patients experienced worsened acne conditions, highlighting the need for holistic care and support during these challenging times.The idea of the article is good, but there are still some problems that need to be corrected.

1.Is there any problem with the layout of Table1 and Figure1? The dividing line in Table1 will be shorter, and will A, B, C, and D be much better used in Figure1 for 1a,1b,1c, and 1d?

2.The pie picture in Figure2 is too fuzzy, can you update it with software? R is a good choice.

3.A very fatal problem, there is no detail statistic method in the whole article, what software do you use to make statistics, software is not pointed out in the article, the method link in the article can not be omitted.

Minor editing of English language required

Author Response

1) I changed the layout of Figure 1 and Table 1

2) I tried to improve Figure 2 resolution

3) I've implemented the study's statistical methodology.

Author Response File: Author Response.docx

Reviewer 2 Report

To make the study relevant, data should be collected both during and after the pandemic. It is not clear whether the stress identified in these patients, along with depression and anxiety, is caused by the pandemic or by the condition they are suffering from, namely acne. As it is well-known and mentioned in the article, acne in adolescents can have a significant psychosocial impact. The Results section is difficult to read and should be restructured so that the reader can quickly assess the obtained results. The Discussion section should be more detailed, and the results should be related to the available studies in the medical literature. The bibliography reference list includes only 16 titles, which represents insufficient research for the addressed topic.

If accepted for resubmission, it is needed to check again for any typos and other issues.

Author Response

Although there are only 16 references in the bibliography, there aren't many studies on the topic

I tried to make the "results" and "discussion" sessions more understandable and simple

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

The authors have improved the manuscript in accordance with the suggested recommendations, and the current version of the article is significantly better compared to the previous one. I believe the article can be published in its current form.