title: A photonumeric scale for the assessment of cutaneous photodamage.
abstract: METHODS
  The assessment of the severity of cutaneous photodamage and its response to treatment is an impractical consideration for most practitioners without extensive experience or recourse to high-quality, standardized, baseline photographs. To address this problem, a nine-point photonumeric standard scale was developed using photographs of subjects representing grades of photodamage from none to severe. This scale was formally tested in a side-by-side comparison with a conventional and widely used written descriptive scale. A panel of seven graders used both scales to score two sets of 25 photographs of photodamaged individuals, and the intergrader agreement and repeatability for the scales were calculated.
  
  
  RESULTS
  The photonumeric scale demonstrated significantly greater agreement between graders than did the descriptive scale (chance-corrected agreements of 0.31 and 0.11, respectively, P less than .0001) with no significant difference in repeatability between the two methods.
  
  
  CONCLUSIONS
  This study demonstrates that the photonumeric standard scale is superior to existing methodology in the accurate assessment of cutaneous photodamage and would be a useful adjunct to studies of the efficacy of skin repair agents for this indication.
authors.affiliation: Department of Dermatology, University of Michigan Medical Center, Ann Arbor 48109-0314.
authors.forename: C E
authors.initials: CE
authors.lastname: Griffiths
authors.forename: T S
authors.initials: TS
authors.lastname: Wang
authors.forename: T A
authors.initials: TA
authors.lastname: Hamilton
authors.forename: J J
authors.initials: JJ
authors.lastname: Voorhees
authors.forename: C N
authors.initials: CN
authors.lastname: Ellis
mesh_terms: D006801:Humans; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015595:Skin Aging