Validated Assessment Scales for Décolleté Wrinkling and Pigmentation.
BACKGROUND
Décolleté aging includes skin dyspigmentation, laxity, and visible wrinkling. The development of globally accepted scales for the assessment of décolleté aging is essential for aesthetic research and patient evaluation.


OBJECTIVE
To develop a set of grading scales for the objective assessment of décolleté aging criteria and establish the reliability and validity of these scales.


METHODS
To describe age-related changes to the décolleté, 3 photonumeric grading scales were created and validated: décolleté wrinkles-at rest, décolleté wrinkles-dynamic, and décolleté pigmentation-at rest. Thirteen aesthetic experts rated photographs of the décolleté of 50 women at rest and at dynamic "hand-to-elbow" positions in 2 validation sessions. Responses were analyzed to assess interrater and intrarater reliability.


RESULTS
Interrater and intrarater reliability were both "almost perfect" (≥0.81, intraclass correlation coefficient and weighted kappa) for décolleté wrinkles-dynamic, summary score for décolleté, and estimated age. Reliability was "substantial" (0.61-0.80) for all other décolleté assessments. There was high correlation between all décolleté scales, estimated age, and estimated aesthetic treatment effort.


CONCLUSIONS
Consistent outcomes between raters and by individual raters at different time points confirm the reliability of the décolleté grading scales, indicating that they will be a valuable tool for use in clinical research and practice.
*Dermatology Unit, Wolfson Medical Center, Holon, Israel; †Merz Pharmaceuticals GmbH, Frankfurt, Germany; ‡Department of Plastic Surgery, Wolfson Medical Center, Holon, Israel; §Le Prioldy, Bieuzy les Eaux, France.
Marina
M
Landau
Thorin L
TL
Geister
Lior
L
Leibou
Birgit
B
Blessmann-Gurk
Roman
R
Görtelmeyer
Jacob
J
Frand
Jenny
J
Grice
Rainer
R
Pooth
D000328:Adult; D000367:Age Factors; D000368:Aged; D001415:Back; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D015588:Observer Variation; D010781:Photography; D011187:Posture; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012782:Shoulder; D015595:Skin Aging; D012880:Skin Pigmentation; D013909:Thorax; D034941:Upper Extremity / Q000502:physiology; D055815:Young Adult