title: Skin surface topography grading is a valid measure of skin photoaging.
abstract: BACKGROUND
  The technique of grading the surface topography of sun-exposed skin using silicone impressions of the skin surface is a simple, non-invasive method for measuring skin damage because of sun exposure, but it has never been validated in a community setting.
  
  
  OBJECTIVE
  To investigate the repeatability and validity of using standardly-graded skin impressions as a means of assessing skin photoaging.
  
  
  METHODS
  A random sample of 195 adults aged 18-79 years and living in Nambour, Australia (latitude, 26 degrees South) had a silicone impression taken of the back of the left hand and a 2 mm punch biopsy of the skin at the same site. Silicone impressions were graded twice independently and histological photoaging was determined by two pathologists.
  
  
  RESULTS
  Grading of silicone impressions of skin surface topography was highly repeatable (weighted kappa > 0.8). Compared with those with low skin impression grades (least degeneration), people with high grades were three times more likely to show a high degree of dermal elastosis on skin histology (odds ratio 3.1, 95% confidence interval 1.6, 5.7) after adjusting for age, sex, skin colour, tanning ability, occupational exposure, smoking and height-adjusted weight. Other photoaging changes in the stratum corneum and dermis were also strongly correlated with high grades of damage on skin impressions.
  
  
  CONCLUSIONS
  Grading silicone impressions of skin surface topography is a highly reliable and a valid measure of photoaging and enables prediction of dermal elastosis in a population setting.
authors.affiliation: Population Studies and Human Genetics, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Brisbane, Qld, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Battistutta
authors.forename: Nirmala
authors.initials: N
authors.lastname: Pandeya
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Strutton
authors.forename: Anny
authors.initials: A
authors.lastname: Fourtanier
authors.forename: Sylvie
authors.initials: S
authors.lastname: Tison
authors.forename: Adèle C
authors.initials: AC
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011793:Queensland; D015203:Reproducibility of Results; D012828:Silicones; D015595:Skin Aging / Q000528:radiation effects*; D013472:Sunlight / Q000009:adverse effects*; D013499:Surface Properties
chemical_list: D012828:Silicones