Updating the Fitzpatrick Classification: The Skin Color and Ethnicity Scale
William P. Coleman, Kavita Mariwalla, Pearl E. Grimes
Abstract
BACKGROUND: There has been a significant increase in submissions to scientific journals addressing a broad spectrum of medical and surgical conditions in subjects grouped under the classification of "Skin of Color." Authors, reviewers, and editors have struggled with accurate terminology. OBJECTIVE: To update the Fitzpatrick scale to make it more accurate in stratifying various shades of skin color. MATERIALS AND METHODS: A thorough literature review was performed using PubMed and Embase to assess existing skin color scales, and an extensive internet search was conducted using makeup foundation ranges as a starting point for skin tone matching. RESULTS: The research resulted in a consensus that Fitzpatrick types 4 and 5 ratings were the most confusing in that these included a broad range of skin types with different responses to solar radiation, lasers, surgery, and cosmetic products. The authors reached a consensus that subdividing skin types 4 and 5 into "A" and "B" better defined them. The new scale that resulted was labeled the SCE scale (for Skin Color Ethnicity). CONCLUSION: This new updated SCE scale should assist authors in better reporting scientific data in skin of color.