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The Development and Initial Validation of PUMC Localized Scleroderma Facial Aesthetic Index: A Pilot Study

  • Original Article
  • Facial Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Localized scleroderma (LoS) is an autoimmune connective tissue disorder leading to serious long-term aesthetic impairment on patients. Objective evaluation methods are badly needed to facilitate the evaluation of the surgical treatment on individual patients and clinical studies.

Objective

To develop and assess the reliability and validity of Peking Union Medical College LoS facial aesthetic index (PUMC LoSFAI).

Methods

Twelve experts devoted their time and resources in the development and validation. LoS patients in the stable phase were recruited. Reliability and validity was then assessed. LoS patients were evaluated by two plastic surgeons using PUMC LoSFAI and LoS skin damage index (LoSDI). The PUMC LoSFAI comprises 4 domains for the local assessment (surface area of lesion, dyspigmentation, skin thickness and soft tissue atrophy) and 3 domains for the overall assessment (facial symmetry, proportion and profile) to describe LoS facial aesthetic impairment. Face-Q was completed by patients at each visit.

Results

Thirty-two LoS patients had 96 visits, during which 138 lesions were assessed. PUMC LoSFAI and 7 domains demonstrated substantial to excellent inter- and intra-rater reliability (ICC 0.995, κw 0.72-0.91, r 0.85–0.99, respectively). Seven domains considered to be important to extremely important variables (mean rank 3.2–3.8) had high I-CVI (> 0.78) and S-CVI (0.93). PUMC LoSFAI correlated excellently with LoSDI (r = 0.933, P < 0.001), and correlated fairly with Face-Q (r = − 0.399, P = 0.001).

Conclusions

PUMC LoSFAI was developed and evaluated to play as a tool of aesthetic impairment assessment for LoS patients, which may facilitate the evaluation of the treatment on individual patients and clinical studies. PUMC LoSFAI demonstrated high reliability and validity, and further study in larger patient samples is needed to confirm these preliminary findings.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.

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Acknowledgements

We thank the members of Scleroderma Surgical Treatment Center in Peking Union Medical College Hospital: Ru Zhao, MD; Weiqing Huang, MD; Wenyun Ting, MD; Loubin Si, MD; Yang Wang, MD; Zhi Wang, MD; Jiuzuo Huang, MD; Lin Zhu, MD; Hairu Cao, MD; Yanyun Jiang, MD; for helping with the survey.

Funding

This work was supported by the National Key Research and Development Program of China (2016YFA0101003).

Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

    Hayson Chenyu Wang, Xiaojun Wang, Xiao Long, Nanze Yu, Ruijia Dong, Ang Zeng & Hailin Zhang

  2. Department of Allergy and Rheumatology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China

    Shiqi Ling

  3. Radcliffe Department of Medicine, University of Oxford, Oxford, UK

    Elliot Tianyu Sun

  4. Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

    Chang Shu

Authors
  1. Hayson Chenyu Wang
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  2. Shiqi Ling
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  3. Xiaojun Wang
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  4. Xiao Long
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  5. Elliot Tianyu Sun
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  6. Nanze Yu
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  7. Ruijia Dong
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  8. Ang Zeng
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  9. Hailin Zhang
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  10. Chang Shu
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Contributions

Conceptualization, HCW, XL and XW; Methodology, SL and ETS; Validation, NY and RD; Formal Analysis, HCW, and ETS; Investigation and Resources, AZ, HZ and CS; Writing—Original Draft Preparation HCW; Writing—Review and Editing, XW and XL; Supervision, XL and XW; Funding Acquisition, XW.

Corresponding authors

Correspondence to Xiaojun Wang or Xiao Long.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

The institutional review board approved the study.

Informed Consent

Patient informed consent was obtained before entering the study.

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Wang, H.C., Ling, S., Wang, X. et al. The Development and Initial Validation of PUMC Localized Scleroderma Facial Aesthetic Index: A Pilot Study. Aesth Plast Surg 45, 1531–1539 (2021). https://doi.org/10.1007/s00266-020-02111-4

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  • DOI: https://doi.org/10.1007/s00266-020-02111-4

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