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Grade 3 acne is characterized by:

  1. black or dark patches on the skin

  2. open sores, reddish patches

  3. red and inflamed skin, many open and closed comedones

  4. red or pink scaly papules or nodules

The correct answer is: red and inflamed skin, many open and closed comedones

Grade 3 acne is characterized by red and inflamed skin, along with many open and closed comedones. The presence of numerous open and closed comedones, which are commonly known as blackheads and whiteheads, is a key feature of Grade 3 acne. The red and inflamed skin indicates that there is inflammation present in the affected areas. This grade of acne typically requires professional treatment to prevent scarring and manage the condition effectively. Option A is incorrect as black or dark patches on the skin are not typically associated with Grade 3 acne. Option B is incorrect as open sores and reddish patches are not specific characteristics of Grade 3 acne. Option D is incorrect as red or pink scaly papules or nodules are not typically seen in Grade 3 acne cases.