Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Allergy and Rheumatology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
Aesthetic Plast Surg. 2021 Aug;45(4):1531-1539. doi: 10.1007/s00266-020-02111-4. Epub 2021 Jan 15.
Localized scleroderma (LoS) is an autoimmune connective tissue disorder leading to serious long-term aesthetic impairment on patients. Objective evaluation methods are badly needed to facilitate the evaluation of the surgical treatment on individual patients and clinical studies.
To develop and assess the reliability and validity of Peking Union Medical College LoS facial aesthetic index (PUMC LoSFAI).
Twelve experts devoted their time and resources in the development and validation. LoS patients in the stable phase were recruited. Reliability and validity was then assessed. LoS patients were evaluated by two plastic surgeons using PUMC LoSFAI and LoS skin damage index (LoSDI). The PUMC LoSFAI comprises 4 domains for the local assessment (surface area of lesion, dyspigmentation, skin thickness and soft tissue atrophy) and 3 domains for the overall assessment (facial symmetry, proportion and profile) to describe LoS facial aesthetic impairment. Face-Q was completed by patients at each visit.
Thirty-two LoS patients had 96 visits, during which 138 lesions were assessed. PUMC LoSFAI and 7 domains demonstrated substantial to excellent inter- and intra-rater reliability (ICC 0.995, κ 0.72-0.91, r 0.85-0.99, respectively). Seven domains considered to be important to extremely important variables (mean rank 3.2-3.8) had high I-CVI (> 0.78) and S-CVI (0.93). PUMC LoSFAI correlated excellently with LoSDI (r = 0.933, P < 0.001), and correlated fairly with Face-Q (r = - 0.399, P = 0.001).
PUMC LoSFAI was developed and evaluated to play as a tool of aesthetic impairment assessment for LoS patients, which may facilitate the evaluation of the treatment on individual patients and clinical studies. PUMC LoSFAI demonstrated high reliability and validity, and further study in larger patient samples is needed to confirm these preliminary findings.
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局限性硬皮病（LoS）是一种自身免疫性结缔组织疾病，可导致患者出现严重的长期美观损害。迫切需要客观的评估方法来促进对个体患者的手术治疗评估和临床研究。
开发和评估北京协和医学院 LoS 面部美学指数（PUMC LoSFAI）的可靠性和有效性。
12 名专家投入时间和资源进行开发和验证。招募稳定期的 LoS 患者，然后评估可靠性和有效性。两位整形外科医生使用 PUMC LoSFAI 和 LoS 皮肤损伤指数（LoSDI）对 LoS 患者进行评估。PUMC LoSFAI 包括 4 个局部评估域（病变面积、色素沉着异常、皮肤厚度和软组织萎缩）和 3 个整体评估域（面部对称性、比例和轮廓），以描述 LoS 面部美学损害。每位患者在每次就诊时都完成了 Face-Q。
32 名 LoS 患者共 96 次就诊，评估了 138 处病变。PUMC LoSFAI 和 7 个领域的组内和组间可靠性均达到了很高的水平（ICC 0.995、κ 0.72-0.91、r 0.85-0.99）。被认为是重要到非常重要的变量的 7 个领域（平均秩 3.2-3.8）具有较高的 I-CVI（>0.78）和 S-CVI（0.93）。PUMC LoSFAI 与 LoSDI 具有极好的相关性（r = 0.933，P<0.001），与 Face-Q 具有相当的相关性（r =-0.399，P = 0.001）。
开发并评估了 PUMC LoSFAI 作为 LoS 患者美学损害评估工具，可能有助于对个体患者的治疗评估和临床研究。PUMC LoSFAI 具有较高的可靠性和有效性，需要在更大的患者样本中进行进一步研究来证实这些初步发现。
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