Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population

Posted in Articles, Health/Medicine/Genetics, Media Archive on 2014-06-13 22:34Z by Steven

Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population

Journal of the American Academy of Dermatology
Available online: 2014-06-11
DOI: 10.1016/j.jaad.2014.05.023

Steven Y. He, BS
Department of Dermatology
University of California, San Francisco

Charles E. McCulloch, PhD
Department of Epidemiology and Biostatistics
University of California, San Francisco

W. John Boscardin, PhD
Department of Epidemiology and Biostatistics; Department of Medicine
University of California, San Francisco

Mary-Margaret Chren, MD
Department of Dermatology
University of California, San Francisco

Eleni Linos, MD, MPH, DrPH
Department of Dermatology
University of California, San Francisco

Sarah T. Arron, MD, PhD
Department of Dermatology
University of California, San Francisco

Background

Fitzpatrick skin phototype (FSPT) is the most common method used to assess sunburn risk and is an independent predictor of skin cancer risk. Because of a conventional assumption that FSPT is predictable based on pigmentary phenotypes, physicians frequently estimate FSPT based on patient appearance.

Objective

We sought to determine the degree to which self-reported race and pigmentary phenotypes are predictive of FSPT in a large, ethnically diverse population.

Methods

A cross-sectional survey collected responses from 3386 individuals regarding self-reported FSPT, pigmentary phenotypes, race, age, and sex. Univariate and multivariate logistic regression analyses were performed to determine variables that significantly predict FSPT.

Results

Race, sex, skin color, eye color, and hair color are significant but weak independent predictors of FSPT (P < .0001). A multivariate model constructed using all independent predictors of FSPT only accurately predicted FSPT to within 1 point on the Fitzpatrick scale with 92% accuracy (weighted kappa statistic 0.53).

Limitations

Our study enriched for responses from ethnic minorities and does not fully represent the demographics of the US population.

Conclusions

Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by FSPT. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk.

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