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New dyspigmentation scale validated


Photo by: Kylie Aquino via Flickr

Researchers have validated a novel scale for analyzing hyperpigmentation in a diverse U.S. population of varying skin tones. The scale is intended to be used for easy characterization of pigment changes due to any cause, anywhere on the body.


In their paper, (JAAD March 19, 2024, online ahead of print) the authors note the Investigator’s Global Assessment is typically used to measure the severity of skin changes from inflammatory diseases but has no specific variable for dyspigmentation. They also note the recent Postinflammatory Dyspigmentation Area and Severity Index (PIDASI) only allows for one pigmentation score regardless of the heterogeneity of pigmentation.


Their study aimed to validate the PIDASI scoring tool in a diverse U.S.-based patient population and to assess the performance of a novel Post Inflammatory Hyperpigmentation Area and Severity Index (PIHASI) scale that captures post-inflammatory hyperpigmentation, or PIH.


“Our study demonstrates that both the PIDASI and PIHASI tools perform well in patients of a variety of skin types with post-inflammatory hyperpigmentation and are reliable and valid alternatives to the commonly used metric to measure the severity of skin changes from inflammatory diseases,” said corresponding author Neelam Vashi, MD, in a press release. Dr. Vashi is an Associate Professor of Dermatology at Boston University Chobanian & Avedisian School of Medicine and director of the Boston University Cosmetic and Laser Center at Boston Medical Center. 


In the study, patients with hyperpigmentation were examined using colourimetry and standardized photographs. Expert dermatologists and dermatology residents then graded the hyperpigmentation on three scales; the scale they created (PIHASI), the PIDASI, and the industry standard. They found that both PIDASI and PIHASI corresponded to objective measurements of disease severity.


According to the researchers, the PIHASI scale will allow providers to better characterize a patient's hyperpigmentation and will be vital in hyperpigmentation research to better quantify response to treatment. “As the scale is simpler than the PIDASI, it can also be used in clinics during patient encounters to understand improvement in hyperpigmentation across time,” said Dr. Vashi.

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