Abstract
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.
Highlights
Non-melanoma skin cancers are the most common form of malignancy within North America, whose prevalence is only rising with nearly 3.5 million cases diagnosed within the United States alone each year
This is associated with a substantial financial impact, currently estimated at $5 billion to treat non-melanoma skin cancers (NMSCs), including basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) [1]
Skin pathologies related to photodamage include precancerous actinic keratosis, which can progress into basal cell carcinoma and squamous cell carcinoma
Summary
Non-melanoma skin cancers are the most common form of malignancy within North America, whose prevalence is only rising with nearly 3.5 million cases diagnosed within the United States alone each year. This is associated with a substantial financial impact, currently estimated at $5 billion to treat non-melanoma skin cancers (NMSCs), including basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) [1]. Skin pathologies related to photodamage include precancerous actinic keratosis, which can progress into basal cell carcinoma and squamous cell carcinoma. Classified as pre-cancerous, AK progression to NMSC is variable.
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