Journal of Clinical and Investigative Dermatology

Research Article

Inter- and Intra-Physician Variation in Quantifying Actinic Keratosis Skin Photodamage

Schmeusser B1, Borchers C1, Travers JB1,3,5, Borchers S3, Trevino J3, Rubin M3, Donnelly H3, Kellawan K3, Carpenter L3, Bahl S3, Rohan C3, Muennich E3, Guenthner S5, Hahn H3, Ali Rkein3, Darst M6, Mousdicas N7, Cates E1, Sunar U2 and Bihl T1,2*

1Department of Pharmacology & Toxicology, Boonshoft School of Medicine, USA
2Department of Biomedical, Industrial & Human Factors Engineering, USA
3Department of Dermatology, Boonshoft School of Medicine, USA
4Dayton Veterans Administration Medical Center, USA
5The Indiana Clinical Trials Center, PC, USA
6Charlotte Dermatology, Charlotte, USA
7Richard L. Roudebush VA Medical Center, Indianapolis, USA
*Address for Correspondence: Bihl T, Department of Pharmacology & Toxicology, Boonshoft School of Medicine, Wright State University, Dayton, OH, 45435, USA, Fax: 937-775-7221, Tel: 937-775-2463, Email: trevor.bihl@wright.edu
Submission: 19 August, 2020; Accepted: 1 September, 2020; Published: 6 September, 2020
Copyright: © 2020 Schmeusser B, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We investigated the variations in physician evaluation of skin photodamage based on a published photodamage scale. Of interest is the utility of a 10-level scale ranging from none and mild photodamage to actinic keratosis (AK). The dorsal forearms of 55 adult subjects with various amounts of photodamage were considered. Each forearm was independently evaluated by 15 board-certified dermatologists according to the Global Assessment Severity Scale ranging from 0 (less severe) to 9 (the most progressed stage of skin damage). Dermatologists rated the levels of photodamage based upon the photographs in blinded fashion. Results show substantial disagreement amongst the dermatologists on the severity of photodamage. Our results indicate that ratings could be more consistent if using a scale of less levels (3-levels). Ultimately, clinicians can use this knowledge to provide better interpretation of inter-rater evaluations and provide more reliable assessment and frequent monitoring of high-risk populations.