title: A validated photonumeric cellulite severity scale.
abstract: BACKGROUND
  With recent advances in the treatment of cellulite and localized fat, a comprehensive objective method of measuring cellulite can be potentially useful, especially since important morphological aspects of cellulite are not part of the current classification. Objective To develop and to validate a new photonumeric cellulite severity.
  
  
  METHODS
  Based on standardized photographs of 55 patients with cellulite, five key morphological aspects of cellulite were identified. A new photonumeric severity scale was developed and validated.
  
  
  RESULTS
  The five key morphological features of cellulite were identified and included the number of depressions, depth of depressions, clinical appearance of evident raised lesions, and presence of flaccidity and the grade of cellulite. Each item was graded from 0 to 3, allowing final classification of cellulite as mild, moderate, and severe. Results for validation of the scale are statistically significant (P < 0.05) and are as follows: intraclass correlation coefficient > 0.7; correlation item-total > 0.7, with the exception of the right buttock; intraclass correlation coefficients 0.881-0.922; Cronbach's alpha 0.851-0.989 and factor analysis 68-76%.
  
  
  CONCLUSIONS
  The proposed photonumeric scale is a consistent, comprehensive, reliable, and reproducible tool for the standardized and objective assessment of the severity of cellulite. Conflicts of interest The authors hereby affirm that neither the manuscript nor any part of it has been published or is being considered for publication elsewhere.
authors.affiliation: School of Medicine, University of Passo Fundo, Passo Fundo, Brazil. dohexsel@terra.com.br
authors.forename: D M
authors.initials: DM
authors.lastname: Hexsel
authors.forename: T
authors.initials: T
authors.lastname: Dal'forno
authors.forename: C L
authors.initials: CL
authors.lastname: Hexsel
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D006801:Humans; D012720:Severity of Illness Index