Schmeusser Benjamin, Borchers Christina, Travers Jeffrey B, Borchers Samia, Trevino Julian, Rubin Max, Donnelly Heidi, Kellawan Karl, Carpenter Lydia, Bahl Shalini, Rohan Craig, Muennich Elizabeth, Guenthner Scott, Hahn Holly, Rkein Ali, Darst Marc, Mousdicas Nico, Cates Elizabeth, Sunar Ulas, Bihl Trevor
Department of Pharmacology & Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH, 45435, USA.
Department of Dermatology, Boonshoft School of Medicine, Wright State University, Dayton, OH, 45435, USA.
J Clin Investig Dermatol. 2020 Sep;8(2). Epub 2020 Sep 6.
We investigated the variations in physician evaluation of skin photodamage based on a published photodamage scale. Of interest is the utility of a 10-level scale ranging from none and mild photodamage to actinic keratosis (AK). The dorsal forearms of 55 adult subjects with various amounts of photodamage were considered. Each forearm was independently evaluated by 15 board-certified dermatologists according to the Global Assessment Severity Scale ranging from 0 (less severe) to 9 (the most progressed stage of skin damage). Dermatologists rated the levels of photodamage based upon the photographs in blinded fashion. Results show substantial disagreement amongst the dermatologists on the severity of photodamage. Our results indicate that ratings could be more consistent if using a scale of less levels (5-levels or 3-levels). Ultimately, clinicians can use this knowledge to provide better interpretation of inter-rater evaluations and provide more reliable assessment and frequent monitoring of high-risk populations.
我们基于已发表的光损伤量表，研究了医生对皮肤光损伤评估的差异。值得关注的是一个从无和轻度光损伤到光化性角化病（AK）的10级量表的实用性。我们纳入了55名有不同程度光损伤的成年受试者的前臂背侧。每位皮肤科医生根据从0（不太严重）到9（皮肤损伤最严重阶段）的全球评估严重程度量表，对每只前臂进行独立评估。皮肤科医生以盲法根据照片对光损伤程度进行评分。结果显示，皮肤科医生在光损伤严重程度上存在很大分歧。我们的结果表明，如果使用级别较少的量表（5级或3级），评分可能会更一致。最终，临床医生可以利用这些知识，更好地解读评分者间的评估结果，并对高危人群进行更可靠的评估和频繁监测。
