Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris

Stephanie A. Savory; Nnenna G. Agim; Rui Mao; Shayna Peter; Casey Wang; Gerardo Maldonado; Jessica Bearden Dietert; Tiffany Jane Lieu; Christy Wang; Kara Pretzlaff; Shinjita Das; Travis Vandergriff; Isha E. Lopez; Brandon R. Litzner; Linda S. Hynan; Maria Ivonne Arellano-Mendoza; Paul R. Bergstresser; Amit G. Pandya

doi:10.1016/j.jaad.2013.09.017

Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris

Stephanie A. Savory, Nnenna G. Agim, Rui Mao, Shayna Peter, Casey Wang, Gerardo Maldonado, Jessica Bearden Dietert, Tiffany Jane Lieu, Christy Wang, Kara Pretzlaff, Shinjita Das, Travis Vandergriff, Isha E. Lopez, Brandon R. Litzner, Linda S. Hynan, Maria Ivonne Arellano-Mendoza, Paul R. Bergstresser, Amit G. Pandya

Research output: Contribution to journal › Article › peer-review

33 Scopus citations

Abstract

Background There are no validated outcome measures for postinflammatory hyperpigmentation (PIH). Objective We sought to determine the reliability and validity of an outcome measure for PIH after acne in patients with skin of color. Methods A postacne hyperpigmentation index (PAHPI) was developed. Six raters scored 21 patients with PIH twice. Reliability was determined within and between raters, whereas validity was evaluated by comparing scores with severity ranking by an independent dermatologist. The pigment intensity scores were compared with the melanin index of each patient using a narrowband reflectance spectrophotometer. A quality-of-life score (Skindex-29) was also compared with PAHPI scores. Results Total PAHPI scores showed good reliability within and between raters and were valid when compared with clinical severity and melanin indices. Good correlation was achieved between the total PAHPI score and the emotion subscale of the Skindex-29. Limitations Generalizability of results is limited to African American females. Conclusion The PAHPI shows good reliability and validity when scored on patients with PIH from acne vulgaris. The PAHPI also correlates well with the emotional impact of PIH as measured by the Skindex-29. Future studies should assess the ability of the PAHPI to change with improvement of PIH from acne after treatment.

Original language	English (US)
Pages (from-to)	108-114
Number of pages	7
Journal	Journal of the American Academy of Dermatology
Volume	70
Issue number	1
DOIs	https://doi.org/10.1016/j.jaad.2013.09.017
State	Published - Jan 2014

Keywords

acne vulgaris
clinical trials
evidence-based medicine
hyperpigmentation
outcome measures
pigment
pigmentation
postinflammatory
postinflammatory hypermelanosis
skin of color
validation

ASJC Scopus subject areas

Dermatology

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10.1016/j.jaad.2013.09.017

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Savory, S. A., Agim, N. G., Mao, R., Peter, S., Wang, C., Maldonado, G., Bearden Dietert, J., Lieu, T. J., Wang, C., Pretzlaff, K., Das, S., Vandergriff, T., Lopez, I. E., Litzner, B. R., Hynan, L. S., Arellano-Mendoza, M. I., Bergstresser, P. R., & Pandya, A. G. (2014). Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris. Journal of the American Academy of Dermatology, 70(1), 108-114. https://doi.org/10.1016/j.jaad.2013.09.017

Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris. / Savory, Stephanie A.; Agim, Nnenna G.; Mao, Rui et al.
In: Journal of the American Academy of Dermatology, Vol. 70, No. 1, 01.2014, p. 108-114.

Research output: Contribution to journal › Article › peer-review

Savory, SA, Agim, NG, Mao, R, Peter, S, Wang, C, Maldonado, G, Bearden Dietert, J, Lieu, TJ, Wang, C, Pretzlaff, K, Das, S, Vandergriff, T, Lopez, IE, Litzner, BR, Hynan, LS, Arellano-Mendoza, MI, Bergstresser, PR & Pandya, AG 2014, 'Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris', Journal of the American Academy of Dermatology, vol. 70, no. 1, pp. 108-114. https://doi.org/10.1016/j.jaad.2013.09.017

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title = "Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris",

abstract = "Background There are no validated outcome measures for postinflammatory hyperpigmentation (PIH). Objective We sought to determine the reliability and validity of an outcome measure for PIH after acne in patients with skin of color. Methods A postacne hyperpigmentation index (PAHPI) was developed. Six raters scored 21 patients with PIH twice. Reliability was determined within and between raters, whereas validity was evaluated by comparing scores with severity ranking by an independent dermatologist. The pigment intensity scores were compared with the melanin index of each patient using a narrowband reflectance spectrophotometer. A quality-of-life score (Skindex-29) was also compared with PAHPI scores. Results Total PAHPI scores showed good reliability within and between raters and were valid when compared with clinical severity and melanin indices. Good correlation was achieved between the total PAHPI score and the emotion subscale of the Skindex-29. Limitations Generalizability of results is limited to African American females. Conclusion The PAHPI shows good reliability and validity when scored on patients with PIH from acne vulgaris. The PAHPI also correlates well with the emotional impact of PIH as measured by the Skindex-29. Future studies should assess the ability of the PAHPI to change with improvement of PIH from acne after treatment.",

keywords = "acne vulgaris, clinical trials, evidence-based medicine, hyperpigmentation, outcome measures, pigment, pigmentation, postinflammatory, postinflammatory hypermelanosis, skin of color, validation",

author = "Savory, {Stephanie A.} and Agim, {Nnenna G.} and Rui Mao and Shayna Peter and Casey Wang and Gerardo Maldonado and {Bearden Dietert}, Jessica and Lieu, {Tiffany Jane} and Christy Wang and Kara Pretzlaff and Shinjita Das and Travis Vandergriff and Lopez, {Isha E.} and Litzner, {Brandon R.} and Hynan, {Linda S.} and Arellano-Mendoza, {Maria Ivonne} and Bergstresser, {Paul R.} and Pandya, {Amit G.}",

note = "Funding Information: Supported by an unrestricted grant from Galderma International . ",

year = "2014",

month = jan,

doi = "10.1016/j.jaad.2013.09.017",

language = "English (US)",

volume = "70",

pages = "108--114",

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T1 - Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris

AU - Savory, Stephanie A.

AU - Agim, Nnenna G.

AU - Mao, Rui

AU - Peter, Shayna

AU - Wang, Casey

AU - Maldonado, Gerardo

AU - Bearden Dietert, Jessica

AU - Lieu, Tiffany Jane

AU - Wang, Christy

AU - Pretzlaff, Kara

AU - Das, Shinjita

AU - Vandergriff, Travis

AU - Lopez, Isha E.

AU - Litzner, Brandon R.

AU - Hynan, Linda S.

AU - Arellano-Mendoza, Maria Ivonne

AU - Bergstresser, Paul R.

AU - Pandya, Amit G.

N1 - Funding Information: Supported by an unrestricted grant from Galderma International .

PY - 2014/1

Y1 - 2014/1

N2 - Background There are no validated outcome measures for postinflammatory hyperpigmentation (PIH). Objective We sought to determine the reliability and validity of an outcome measure for PIH after acne in patients with skin of color. Methods A postacne hyperpigmentation index (PAHPI) was developed. Six raters scored 21 patients with PIH twice. Reliability was determined within and between raters, whereas validity was evaluated by comparing scores with severity ranking by an independent dermatologist. The pigment intensity scores were compared with the melanin index of each patient using a narrowband reflectance spectrophotometer. A quality-of-life score (Skindex-29) was also compared with PAHPI scores. Results Total PAHPI scores showed good reliability within and between raters and were valid when compared with clinical severity and melanin indices. Good correlation was achieved between the total PAHPI score and the emotion subscale of the Skindex-29. Limitations Generalizability of results is limited to African American females. Conclusion The PAHPI shows good reliability and validity when scored on patients with PIH from acne vulgaris. The PAHPI also correlates well with the emotional impact of PIH as measured by the Skindex-29. Future studies should assess the ability of the PAHPI to change with improvement of PIH from acne after treatment.

AB - Background There are no validated outcome measures for postinflammatory hyperpigmentation (PIH). Objective We sought to determine the reliability and validity of an outcome measure for PIH after acne in patients with skin of color. Methods A postacne hyperpigmentation index (PAHPI) was developed. Six raters scored 21 patients with PIH twice. Reliability was determined within and between raters, whereas validity was evaluated by comparing scores with severity ranking by an independent dermatologist. The pigment intensity scores were compared with the melanin index of each patient using a narrowband reflectance spectrophotometer. A quality-of-life score (Skindex-29) was also compared with PAHPI scores. Results Total PAHPI scores showed good reliability within and between raters and were valid when compared with clinical severity and melanin indices. Good correlation was achieved between the total PAHPI score and the emotion subscale of the Skindex-29. Limitations Generalizability of results is limited to African American females. Conclusion The PAHPI shows good reliability and validity when scored on patients with PIH from acne vulgaris. The PAHPI also correlates well with the emotional impact of PIH as measured by the Skindex-29. Future studies should assess the ability of the PAHPI to change with improvement of PIH from acne after treatment.

KW - acne vulgaris

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KW - evidence-based medicine

KW - hyperpigmentation

KW - outcome measures

KW - pigment

KW - pigmentation

KW - postinflammatory

KW - postinflammatory hypermelanosis

KW - skin of color

KW - validation

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Reliability assessment and validation of the postacne hyperpigmentation index (PAHPI), a new instrument to measure postinflammatory hyperpigmentation from acne vulgaris

Abstract

Keywords

ASJC Scopus subject areas

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