Development and Validation of a Clinical Scale for the Evaluation of Forearm Skin Photoaging

Guimara~es, Carolina Okada Zerbini; Bagatin, Ediléia; Guadanhim, Lilia Ramos dos Santos; Sternberg, Flavia; Picosse, Fabíola Rosa; Nunes, Gisele Jacobino de Barros; Milanez, C.; Miot, Hélio Amante

doi:10.1177/1203475415574946

Cited by 18 publications

(22 citation statements)

References 15 publications

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“…The Institutional Review Board approved the study protocol, and consent form signatures were obtained. Subjects were divided into three groups according to their forearm skin photoageing degree, assessed by a validated clinical scale described below: Group 1 – light photoageing (score from 0 to 30); Group 2 –moderate photoageing (score from 31 to 70); and Group 3 – advanced photoageing (score from 71 to 100).…”

Section: Methodsmentioning

confidence: 99%

Reliable assessment of forearm photoageing by high‐frequency ultrasound: a cross‐sectional study

Caetano

Soares

Bagatin

et al. 2015

Intern J of Cosmetic Sci

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Section: Methodsmentioning

confidence: 99%

Reliable assessment of forearm photoageing by high‐frequency ultrasound: a cross‐sectional study

Caetano

Soares

Bagatin

et al. 2015

Intern J of Cosmetic Sci

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“…It is possible that the dorsal surface of the upper extremities is also exposed to similar levels of UV exposure. While exposure of skin to UV radiation promotes Vitamin D synthesis, chronic exposure causes photoage‐related degenerative changes that impact cellular, fibrous, and vascular skin structures . The cumulative effects of UV radiation on exposed skin surfaces have been shown to clinically manifest as elastotic skin changes, purpura, uneven skin pigmentation and melanoma and non‐melanoma skin lesions …”

Section: Discussionmentioning

confidence: 99%

“…While exposure of skin to UV radiation promotes Vitamin D synthesis, chronic exposure causes photoage-related degenerative changes that impact cellular, fibrous, and vascular skin structures. [47][48][49][50] The cumulative effects of UV radiation on exposed skin surfaces have been shown to clinically manifest as elastotic skin changes, purpura, uneven skin pigmentation and melanoma and non-melanoma skin lesions. [51][52][53][54][55][56][57][58] Despite a broad range of individual attributes, skin characteristics, and skin properties being assessed, this study may not have identified all factors that could contribute to the risk of skin tears.…”

Section: Discussionmentioning

confidence: 99%

A risk model for the prediction of skin tears in aged care residents: A prospective cohort study

Rayner

Carville

Leslie

et al. 2018

International Wound Journal

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The objective of this study was to construct a predictive model to identify aged care residents at risk of future skin tears. Extensive data about individual characteristics, skin characteristics, and skin properties were gathered from 173 participants at baseline and at 6 months. A predictive model, developed using multivariable logistic regression, identified five variables that significantly predicted the risk of skin tear at 6 months. These included: a history of skin tears in the previous 12 months (OR 3.82 [1.64-8.90], P = 0.002), purpura ≤20 mm in size (OR 3.64 [1.42-9.35], P = 0.007), a history of falls in the previous 3 months (OR 3.37 [1.54-7.41], P = 0.002), clinical manifestations of elastosis (OR 3.19 [1.38-7.38], P = 0.007), and male gender (OR 3.08 [1.22-7.77], P = 0.017). The predictive model yielded an area under the receiver operating characteristic curve of 0.854 with an 81.7% sensitivity and an 81.4% specificity. This predictive model could inform a simple but promising bedside tool for identifying older individuals at risk of skin tears.

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“…A photographic assessment was obtained from two boarded dermatologists (blinded evaluators). The evaluation was based on the Guimarães scale, which analyses AK, lentigines, wrinkles, elastosis, elasticity, purpura and pseudostellar scars. Photographs were captured with Canon PowerShot G10 digital camera (Canon Inc., Tokyo, Japan) at OMNIA Imaging Station.…”

Section: Methodsmentioning

confidence: 99%

Tretinoin (0.05% cream vs. 5% peel) for photoaging and field cancerization of the forearms: randomized, evaluator‐blinded, clinical trial

Sumita

Miot

Soares

et al. 2018

Acad Dermatol Venereol

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Background Topical tretinoin cream is the gold standard treatment for skin ageing, particularly photoaging. The purpose of tretinoin peel was to obtain similar results, but in a shorter time, however, there have been few controlled trials on its effectiveness. Objective To compare efficacy and safety of tretinoin 0.05% cream and 5% as a peeling agent on photoaging and field cancerization of the forearms. Methods Clinical trial with therapeutic intervention, prospective, randomized (computer‐generated randomization list), parallel, comparative (intrasubject) and evaluator‐blinded (except for histology and immunohistochemistry), including 24 women (48 forearms) aged over 60 years who have not undergone hormone replacement and categorized as Fitzpatrick skin phototype II or III. The forearms of the participants were randomized for treatment with 0.05% tretinoin cream three nights a week, or 5% tretinoin peel every 2 weeks. The opinion of the participant, severity of photoaging, corneometry, profilometry, high‐frequency ultrasound, histology (haematoxylin–eosin and Verhoeff stainings) and immunohistochemistry (p53, bcl‐2, Ki67 and collagen I) were assessed. Results One participant dropped out. The mean photoaging score reduced 20% and the mean actinic keratosis (AK) count reduced 60% with no difference between treatments. Three efficacy parameters showed opposite effects between the tretinoin treatments (P < 0.05%): (i) thickness of the corneal layer decreased with 0.05% tretinoin and increased by 5%; (ii) dermis echogenicity increased by 0.05% and decreased by 5% and (iii) Ki67 expression increased by 0.05% and decreased by 5%. There was good tolerability for both regimens. Conclusion Tretinoin as a cream 0.05% or peeling (5%) is safe and effective for the treatment of moderate photoaging and forearm field cancerization. The cream was superior in improving ultrasonographic parameters of ageing. Peeling was shown a superior performance in the stabilization of field cancerization.

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Development and Validation of a Clinical Scale for the Evaluation of Forearm Skin Photoaging

Abstract: A validated clinical photoaging scale for forearms with internal consistency, reliability, and validity was developed.

Cited by 18 publications

References 15 publications

Reliable assessment of forearm photoageing by high‐frequency ultrasound: a cross‐sectional study

Reliable assessment of forearm photoageing by high‐frequency ultrasound: a cross‐sectional study

A risk model for the prediction of skin tears in aged care residents: A prospective cohort study

Tretinoin (0.05% cream vs. 5% peel) for photoaging and field cancerization of the forearms: randomized, evaluator‐blinded, clinical trial

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