title: Visual assessment of facial elastosis using photographs as a measure of cumulative ultraviolet exposure.
abstract: Because solar ultraviolet (UV) exposure is ubiquitous, it is difficult to quantify in human populations. We developed a method to index cumulative UV damage, based upon visual manifestations of facial actinic elastosis. Four photographic slides were taken of each subject's facial skin. These slides were projected on a screen and graded by consensus of 2 raters using a 5-point relative severity scale. Rating disagreements were resolved by a skilled dermatologist who acted as adjudicator. High photographic quality was maintained by standardization of camera settings, lighting, and photographic techniques. Inter- and intrarater variability in grading was minimized by training using standard slides and by practice. This index has been tested in 2 large epidemiologic studies. The method proved highly reliable and, within categories of age and tanning ability, a valid measure of cumulative UV exposure. In addition, this method appeared superior to others in speed, ease of use and cost.
authors.affiliation: Division of Occupational Medicine, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland.
authors.forename: L L
authors.initials: LL
authors.lastname: Cameron
authors.forename: B C
authors.initials: BC
authors.lastname: Vitasa
authors.forename: P G
authors.initials: PG
authors.lastname: Lewis
authors.forename: H R
authors.initials: HR
authors.lastname: Taylor
authors.forename: E A
authors.initials: EA
authors.lastname: Emmett
mesh_terms: D004547:Elastic Tissue; D005069:Evaluation Studies as Topic; D005145:Face; D006801:Humans; D010781:Photography / Q000295:instrumentation / Q000379:methods*; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology*; D013472:Sunlight / Q000009:adverse effects*; D014466:Ultraviolet Rays / Q000009:adverse effects*