Advancing in the assessment of skin changes through validated measurement scales: a systematic review

Traditional clinical observations are the gold standard for early diagnosis and treatment of wounds. However, the exclusive use of clinical inspection increases the changes of diagnostic inaccuracies due to the subjectivity of the evaluator. The application of scales in the evaluation of skin changes can more reliably and effectively guide patient management. The objective of this study is to conduct an integrative literature review of studies that involve the validation of measurement scales for the evaluation of skin changes in various pathologies. The PUBMED, MEDLINE, and LILACS databases were used for the literature search on the subject. The review prioritized the selection of studies that address validated scales for the assessment of skin changes in different pathological conditions. A brief evolution in the scientific field on the topic was observed, particularly between the years 2012 and 2016. The most significant publications were concentrated in the United States and Brazil, suggesting a greater interest in studies on validated measurement scales for wounds. The types of studies selected in the articles were distributed among retrospective, prospective, cross-sectional cohorts, randomized, and combined research with both prospective and retrospective elements. The most evaluated characteristics by the scales included erythema, abscess, dryness, papules, redness, desquamation, cellulitis, and irritation. The diversity of the structures of the scales validated by the studies and the different types of scores for wound evaluation were also highlighted. The scales were notably applied in various clinical aspects, including skin integrity and discomfort, inflammatory aspects, eruptions, pruritus, infections, pigmentation, and healing. The skin, as a protective barrier of the body, can be compromised by the occurrence of severe pathological conditions. The skin, as a protective barrier of the body, can be compromised by the occurrence of severe pathological conditions. The use of measurement tools, combined with clinical observation commonly performed by professionals, implies potential improvement in patient management. As seen, several scales have potential validity, depending on the pathology studied. Thus, they also serve as a basis for the development of new scales for other diseases.