Development of a new classification and scoring system for scalp conditions: Scalp Photographic Index (SPI)

Abstract

Background and objectives

There has been no validated tool for objectively quantifying the overall condition and characteristics of the scalp. This study aimed to establish and validate a new classification and scoring system for evaluating scalp conditions.

Methods

The Scalp Photographic Index (SPI) using a trichoscope grades five features of scalp conditions (dryness, oiliness, erythema, folliculitis, and dandruff) on a score of 0–3. To evaluate the validity of SPI, SPI grading was performed by three experts on the scalps of 100 subjects along with a dermatologist’s assessment of the scalps and a scalp-related symptom survey. For reliability assessment, 20 healthcare providers performed SPI grading for the 95 selected photographs of the scalp.

Results

SPI grading and the dermatologist’s scalp assessment showed good correlations for all five scalp features. Warmth showed a significant correlation with all features of SPI and the subjects’ perception of a scalp pimple had a significant positive correlation with the folliculitis feature. SPI grading demonstrated good reliability with excellent internal consistency (Cronbach’s α = 0.90) and strong inter- and intra-rater reliability (Kendall’s W = 0.84, ICC(3,1)=0.94).

Conclusions

SPI is an objective, reproducible, and validated numeric system for classifying and scoring scalp conditions.

Keywords:

• Clinical dermatology
• common skin diseases
• diagnosis
• hair disorders

Acknowledgements

IRB approval status: reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB No. B-2107-697-301).

Consent form

The patients in this manuscript have given written informed consent to publication of their case details.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

For any purpose, with investigator support, anyone can request the data through email-id [email protected]

Additional information

Funding

This study was funded by the Ministry of SMEs and Startups of Korea.