Which skin condition is characterized by both pustules and papules but is more serious than other grades of acne?

The correct choice highlights a skin condition that is marked by the presence of both pustules and papules, and it is classified as more severe than other grades of acne, particularly Grade 1, Grade 2, and Grade 3.

Grade 4 acne, often referred to as cystic acne or nodulocystic acne, features not only the inflammation and lesions that are found in lower grades but also includes deep, painful cysts that can lead to scarring. It involves a significant amount of active lesions, which can dramatically affect a person's skin texture and emotional well-being. The combination of pustules and papules indicates a more aggressive inflammatory response, making it more serious than milder forms like Grades 1 to 3, which typically show less severity in terms of both the number and type of lesions present. The distinction of Grade 4 as the most serious category is critical for determining appropriate treatment strategies, as this condition often requires more intensive medical intervention, such as prescription medications and dermatological procedures.