Accuracy of Self-report in Assessing Fitzpatrick Skin Phototypes I Through VI

Eilers, Steven; Bach, D; Gaber, Rikki; Blatt, Hanz; Guevara, Yanina; Nitsche, K; Kundu, Roopal V.; Robinson, June K.

doi:10.1001/jamadermatol.2013.6101

Cited by 132 publications

(143 citation statements)

References 27 publications

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“…Reflected skin color, a correlate of melanin content (14, 15), was objectively recorded (mean of 6 readings) from both the outer and inner part of the subject's left upper arm using a BYK-Gardner CGSS (Geretsried, Germany) hand-held reflectance spectrophotometer with standard reflectance at 685 nm, calibrated before each session. The multi-wavelength data quantify color using the Commission Internationale de l'Éclairage L* a* b* color space parameters: with dimension L* indicating lightness of color (smaller values indicate darker color), a* the position between red and green and b* the position between yellow and blue (smaller values indicate lighter color) (16).…”

Section: Methodsmentioning

confidence: 99%

Accuracy of Self-Reported Nevus and Pigmentation Phenotype Compared with Clinical Assessment in a Population-Based Study of Young Australian Adults

Cust

Pickles

Goumas

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Awareness of individual risk may encourage improved prevention and early detection of melanoma. Methods We evaluated the accuracy of self-reported pigmentation and nevus phenotype compared to clinical assessment, and examined agreement between nevus counts from selected anatomical regions. The sample included 456 cases with invasive cutaneous melanoma diagnosed between ages 18-39 years and 538 controls from the population-based Australian Melanoma Family Study. Participants completed a questionnaire regarding their pigmentation and nevus phenotype, and attended a dermatologic skin examination. Results There was strong agreement between self-reported and clinical assessment of eye color (kappa, κ, =0.78, 95% confidence interval (CI) 0.74-0.81); and moderate agreement for hair color (κ =0.46, 95% CI 0.42-0.50). Agreement between self-reported skin color and spectrophotometer-derived measurements was poor (κ =0.12, 95% CI 0.08-0.16) to moderate (Spearman correlation rs=-0.37, 95% CI -0.32- to -0.42). Participants tended to under-estimate their nevus counts and pigmentation; men were more likely to under-report their skin color. The rs was 0.43 (95% CI 0.38-0.49) comparing clinical total body nevus counts with self-reported nevus categories. There was good agreement of quartile distributions of total body nevus counts with site-specific nevus counts, particularly on both arms. Conclusions Young adults have sub-optimal accuracy when assessing important risk characteristics including nevus numbers and pigmentation. Measuring nevus count on the arms is a good predictor of full body nevus count. Impact These results have implications for the likely success of targeted public health programs that rely on self-assessment of these factors.

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Section: Methodsmentioning

confidence: 99%

Accuracy of Self-Reported Nevus and Pigmentation Phenotype Compared with Clinical Assessment in a Population-Based Study of Young Australian Adults

Cust

Pickles

Goumas

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…From May to July 2014, a cross-sectional study compared survey responses: color bar tool, skin tone descriptions and the adapted Fitzpatrick skin type questions. 2 Participants’ melanin index was obtained using spectrophotometry (Mexameter MX18 probe, Corage + Khazaka Electronic GmbH, Koln, Germany).…”

mentioning

confidence: 99%

Color bar tool for skin type self-identification: A cross-sectional study

Robinson

2015

Journal of the American Academy of Dermatology

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“…As part of this evolution, the original 4 skin types (I-IV), which assessed sun reactivity with standardized questions about the ease of sun burning and tanning reactions to the first exposure in the summer, were modified by adding SPT V and VI to include those with brown and black skin [1] . Our research demonstrated that the modifications to include people with skin of color were neither culturally sensitive nor accurate, as people of color were unable to respond to the questions of sunburn and tanning [20][21][22] . People with deep pigmentation of the skin did not report turning red or pink but rather experienced "irritation" after sun exposure [20][21][22].…”

Section: Resultsmentioning

confidence: 79%

“…Our research demonstrated that the modifications to include people with skin of color were neither culturally sensitive nor accurate, as people of color were unable to respond to the questions of sunburn and tanning [20][21][22] . People with deep pigmentation of the skin did not report turning red or pink but rather experienced "irritation" after sun exposure [20][21][22]. Another limitation of the six Roman numeral Fitzpatrick SPT integers was the reliance upon a history of sunburn after the first exposure of summer.…”

Section: Resultsmentioning

confidence: 79%

Digital dermoscopy to determine skin melanin index as an objective indicator of skin pigmentation

et al. 2016

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Clinical assessment of skin photosensitivity is subjectively determined by erythema and tanning responses to sunlight recalled by the subject, alternatively known as Fitzpatrick Skin Phototype (SPT). Responses may be unreliable due to recall bias, subjective bias by clinicians and subjects, and lack of cultural sensitivity of the questions. Analysis of red-green-blue (RGB) color spacing of digital images may provide an objective determination of SPT. This paper presents the studies to assess the melanin index (MI), as determined by RGB images obtained by both standard digital camera as well as by videodermoscope, and to correlate the MI with SPT based upon subjects' verbal responses to standardized questions administered by a dermatologist.A sample of subjects representing all SPTs I-VI was selected. Both the digital camera and videodermoscope were calibrated at standard illumination, light source and white balance. Images of constitutive skin of the upper ventral arm were taken of each subject using both instruments. The studies showed that 58 subjects (20 M, 38 F) were enrolled in the study (mean age: 47 years; range: 20-89), stratified to skin phototype I-VI. MI obtained by using both digital camera and videodermoscope increased significantly as the SPT increased (p = 0.004 and p < 0.0001, respectively) and positively correlated with dermatologist-assessed SPT (Spearman correlation, r = 0.48 and r = 0.84, respectively). Digital imaging can quantify melanin content in order to quantitatively approximate skin pigmentation in all skin phototypes including Type VI skin. This methodology holds promise as a simple, non-invasive, rapid and objective approach to reliably determine skin phototype and, with further investigation, may prove to be both practical and useful in the prediction of skin cancer risk.

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Accuracy of Self-report in Assessing Fitzpatrick Skin Phototypes I Through VI

Abstract: clinicaltrials.gov Identifier: NCT01124513.

Cited by 132 publications

References 27 publications

Accuracy of Self-Reported Nevus and Pigmentation Phenotype Compared with Clinical Assessment in a Population-Based Study of Young Australian Adults

Accuracy of Self-Reported Nevus and Pigmentation Phenotype Compared with Clinical Assessment in a Population-Based Study of Young Australian Adults

Color bar tool for skin type self-identification: A cross-sectional study

Digital dermoscopy to determine skin melanin index as an objective indicator of skin pigmentation

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