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Results

Twenty five subjects were enrolled and completed the study. Their baseline
demographics are detailed in Table 1. The baseline acne severity scores were rather
homogeneous among all subjects, except where the use of cleansers before
enrollment were less severely affected by acne.
After 4 weeks of chocolate comsumption, the Leeds revised scores changed from
the beseline values of 2.04 1.10 to 2.48 1.01 (P<0.01). Weekly changes of the
scores are illustrated in figure 1.
When broken down into specific types of lesions, after 4 weeks, comedo counts
increased from a mean of 11.84 8.41 at beseline to 20.28 10.38 (p <0.01;
median 9.0-17.5). similarly, the mean number of inflammatory papules rose from
the beseline value of 6.60 5.26 to 13.70 5.56 (P<0.01; median 4.5 -12.0). The
changes in numbers of pustules and nodules were less dramatic and did not reach
statistically significant levels, i.e., pustules from 03.2 0.63 at beseline to 0.40
0.71; nodules from 0.84 2.43 to 0.28 0.74 (Figs. 2-4).
Interestingly, as seen in figures 1 and 2, the most dramatic increases occurred
during the first 2 weeks followed by increases that were more gradual or plateauing
in the latter 2 weeks. It is clear that from week 2 until the end of the study, the
severity scores were statistically significantly higher than baseline. Similarly, when
specific types of lesions were analyzed, the number of comedones and
inflammatory papules increased significantly from week 2 on.

As our subjects are recruited from those who previously enjoyed having chocolates ,
compliance was excellent. All subjects consumed the prescribed chocolates without
much difficulty. No adverse effects were reported except that some stated that 99%
chocolate tasted rather bitter.

We also assessed factors that may effect acne severity, including types of diet
consumsed during the 4 weeks, hours of sleep, bedtime, stress, etc. none of these
parameters showed statistically significant changes or correlations with acne
severity scores during the 4 weeks of chocolate consumption.