Desenvolvimento e validação de uma escala de gravidade de estrias de distensão

• Autor(a) principal: Freitas, Verena Mony Paes De [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6369597; https://repositorio.unifesp.br/handle/11600/52555
• topic: Striae distensae; Stretch marks; Classification; Illness index severity; Estrias de distensão; Classificação; Gravidade

Introduction: Striae distensae or stretch marks are linear and atrophic lesions, erythematous or hypochromic, commonly present mainly in women. They have typical clinical finds and may vary in severity. The most severe cases may be accompanied by significant negative impact and significant psychological repercussions. Due to its great incidence, its variability in the severity, its diversity of therapeutic options and few instruments to evaluate the degree of improvement, it was decided to develop a striae dintansae severity scale. Objective: To classify the stretch marks in mild, moderate, severe or extremely severe, and develop a Striae Distensae Severity Scale. Methods: A total of 110 areas with strech marks in 45 participants were evaluated for the validation phase, and through a clinical classification performed by experts (Delphi strategy) the following variables were described: topography, number of lesions, length of the longest striae, width of the widest striae, width of the most frequent striae pattern, number of affected quadrants, distribution (isolated or multiple), arrangement (transverse, longitudinal or reticular), hypochromia or hyperchromia, striae rubra (pink, erythematous or violaceous), atrophy, relief and time of onset. The variables were analyzed in the Partial Least Squares (PLS) model to detect the Value of Importance to Projection (VIP) of each one. For the composition of the scale the variables with higher VIP were maintained. In order to evaluate the reproducibility of the scale, 43 regions were evaluated in the retest phase Results: From 110 areas evaluated, 34 were breasts, 24 abdomen and 52 buttocks. Striae considered mild were 30%, moderate 33%, severe 21% and extremely severe 16%. The variables with greater VIP were width of the widest striae, width of the most frequent striae pattern, atrophy, number of affected quadrants, distribution, hypo or hypercromia and topography. The model's severity performance showed a high correlation (rho = 0.76) and the intraclass correlation coefficient was 0.9. Conclusion: A Striae Distensae Severity Scale was developed and validated, which will be of great use for future clinical trials on stretch marks.