The Pillsbury classification classifies acne as Grade I-IV: Grade I (mild) presents with blackheads, disseminated or multiple; scattered inflammatory papules. Grade II (moderate) has an increased number of inflammatory lesions in addition to grade I. Superficial pustules appear, but are confined to the face. Grade III (severe) shows deepening of the inflammatory papules of degree II, which are distributed on the face, neck and chest and back. Grade IV (severe – clustered) presents as grade III plus nodules and cysts with scar formation, occurring on the upper body.