ULTRAVIOLET ERYTHEMA SENSITIVITY IN ANAMNESTIC (I‐IV) and PHOTOTESTED (1–4) CAUCASIAN SKIN PHOTOTYPES: THE NEED FOR A NEW CLASSIFICATION SYSTEM

Abstract

The anamnestic skin phototypes (ASP) I-IV of 22 Caucasian volunteers wee compared with their phototested skin phototypes (PSP) using solar simulating, broadband UV radiation. The Commission Internationale de l'Eclairage (CIE)-weighted (i.e. erythemally effective) minimal erythema doses (MED) for solar simulating radiation varied from 20 mJ/cm2 (PSP type 1) to 57 mJ/cm2 (PSP type 4). In only 11 of 21 volunteers did the ASP (I-IV) and PSP (1-4) classifications coincide, and the MED values of the volunteers within the different ASP groups (I-IV) overlapped considerably. To compare the reactivity to erythematogenic radiation of different wavelengths, narrowband monochromator irradiations were performed at 298 nm, 310 nm and 330 nm. The CIE-weighted MED values at these wavelengths (20-80 mJ/cm2) corresponded well with those obtained in the broadband testing. Our results indicate that, with classification by interrogation, Caucasian skin can reliably be classified into only two subtypes, corresponding to Fitzpatrick phototypes I-III and phototype IV, respectively. A classification into four sensitivity types can be achieved by phototesting, only. We propose that the concept of ASP should be used with caution. The concept of PSP 1-4 should be favored.

Design and evaluation of a novel portable erythema‐melanin‐meter

“…Our observations are consistent with results obtained by other groups [35][36][37][38], who have been trying to verify objectively the procedure of the skin type separation offered by the Fitzpatrick scale [35,37,[39][40][41].…”

Up‐regulation of human epidermal Langerhans' cell B7‐1 and B7‐2 co‐stimulatory molecules in vivo by solar‐simulating irradiation

“…A written informed consent was required from all subjects in advance, and the examination protocol was approved by the Ethical Committee of Turku University Hospital. Small areas on the buttock, not exposed to sunlight within the previous 2-7 months, were irradiated with the HP 3136 UV source (Philips, Helsinki, Finland) emitting a solar-simulating spectrum [14]. The majority of the irradiation experiments (13/15) were performed between October and April.…”

Assessing the role of race in quantitative measures of skin pigmentation and clinical assessments of photosensitivity

“…Several articles have subsequently recognized the role of ethnicity in skin phototyping, pointing out that people with ''skin of color'' or ''ethnic skin'' are principally typed as PSPT IV, V, and VI. 3,4 Others have criticized the PSPT as unreliable, 5,6 and the PSPT designation has been determined to correlate poorly with skin color. 7,8 Another clinical measure used to predict photosensitivity is the minimal erythema dose (MED), which is based on correlation to E dose-response curves.…”