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Evaluation of dermoscopic photoaging score among multiethnic in Medan, Indonesia

  • Nelva Karmila Jusuf ,
  • Imam Budi Putra ,
  • Medina Muslim ,


Background: Skin is considered a reflection of a person's appearance, so it is normal if many people try to take care of their skin, especially facial skin, and retard the aging process. Dermoscopy is a quick, non-invasive technique that allows physicians to observe the skin. Different ethnic groups may show different signs of aging on the face. Medan is a multiethnic city and thus might show facial skin aging differently. This study aimed to evaluate facial skin aging through the Dermoscopic Photoaging Scale (DPAS) and assess the relationship between DPAS, Glogau and Fitzpatrick scales among various ethnic groups in Medan, Indonesia.

Subjects and Methods: This cross-sectional study enrolled 155 subjects from 10 ethnicities in Medan. The examination of facial aging is based on DPAS using 11 criteria, the Glogau scale, and the Fitzpatrick skin type.

Results: Malay and Karonese got the highest DPAS score. There was a significant difference between DPAS, Glogau, and Fitzpatrick in age (p = <0.001,<0.001 and 0.032), and Fitzpatrick scores in ethnicity (p <0.001). There was a strong and significant correlation between DPAS and Glogau scores (p < 0.001, r = 0.748), while DPAS and Fitzpatrick's scores showed a moderate and significant correlation (p < 0.001, r = 0.288).

Conclusion: The highest DPAS scores were found in the Malay and Karonese ethnic groups. There were significant differences between DPAS, Glogau, and Fitzpatrick in age and Fitzpatrick scores in ethnicity. There was a strong and significant correlation between DPAS scores and the Glogau scale and a moderate and significant correlation between DPAS and Fitzpatrick scores in various ethnic groups.


  1. Bonté F, Girard D, Archambault J-C, Desmoulière A. Skin Changes During Ageing [Internet]. Subcellular Biochemistry. Springer Singapore; 2019. p. 249–80. Available from:
  2. Assaf H, Adly MA, Hussein MR. Aging and Intrinsic Aging: Pathogenesis and Manifestations [Internet]. Textbook of Aging Skin. Springer Berlin Heidelberg; 2010. p. 129–38. Available from:
  3. Jusuf NK. Broccoli flower extract (Brassica oleracea L. var. italica plenck) inhibits photoaging by increasing type I procollagen expression in human skin fibroblast. 2016;
  4. Kerns M, Chien A, Kang S. Skin Aging. In: Goldsmith L, Katz S, Gilchrest B, Paller A, Leffell D, Wolff K, editors. Fitzpatrick’s dermatology. 9th ed. New York: McGraw Hill; 2019. p. 1779–91.
  5. Bergler-Czop B, Miziołek B. Aging–what do we know? Acta Dermatovenerologica Croat. 2017;25(1):67.
  6. Voegeli R, Rawlings A V, Seroul P, Summers B. A novel continuous colour mapping approach for visualization of facial skin hydration and transepidermal water loss for four ethnic groups. Int J Cosmet Sci. 2015;37(6):595–605. Available from:
  7. Ahmad Z, Damayanti. Penuaan Kulit : Patofisiologi dan Manifestasi Klinis. Berk Ilmu Kesehat Kulit dan Kelamin – Period Dermatology Venereol. 2018;30(03):208–15.
  8. Durai PC, Thappa DM, Kumari R, Malathi M. Aging in elderly: chronological versus photoaging. Indian J Dermatol. 2012;57(5):343–52. Available from:
  9. Ware OR, Dawson JE, Shinohara MM, Taylor SC. Racial limitations of Fitzpatrick skin type. Cutis. 2020;105(2):77–80.
  10. Akay BN, Kocyigit P, Heper AO, Erdem C. Dermatoscopy of flat pigmented facial lesions: diagnostic challenge between pigmented actinic keratosis and lentigo maligna. Br J Dermatol. 2010;163(6):1212–7. Available from:
  11. Lacarrubba F, D’Amico V, Nasca MR, Dinotta F, Micali G. Use of dermatoscopy and videodermatoscopy in therapeutic follow-up: a review. Int J Dermatol. 2010;49(8):866–73. Available from:
  12. Isik B, Gurel MS, Erdemir AT, Kesmezacar O. Development of skin aging scale by using dermoscopy. Ski Res Technol. 2013;19(2):69–74. Available from:
  13. El‐Sayed MH, Saleh HM, El Zawahry KMA, Mostafa AE. The dermoscopic features of facial aging among Egyptians: A comparative study between males and females. J Cosmet Dermatol. 2019;18(6):1803–13. Available from:
  14. Jothishankar B, Stein SL. Impact of skin color and ethnicity. Clin Dermatol. 2019;37(5):418–29. Available from:
  15. Venkatesh S, Maymone MBC, Vashi NA. Aging in skin of color. Clin Dermatol. 2019;37(4):351–7. Available from:
  16. Vierkötter A, Hüls A, Yamamoto A, Stolz S, Krämer U, Matsui MS, et al. Extrinsic skin ageing in German, Chinese and Japanese women manifests differently in all three groups depending on ethnic background, age and anatomical site. J Dermatol Sci. 2016;83(3):219–25. Available from:
  17. Wesley NO, Talakoub L, Maibach HI. Ethnic differences in skin properties [Internet]. Textbook of Cosmetic Dermatology. Informa Healthcare; 2010. p. 395–404. Available from:
  18. Muslim M, Jusuf NK, Putra IB. The dermoscopic features of facial aging among diverse ethnicity in Medan, Indonesia. Bali Med J. 2021;10(2):904–9. Available from:
  19. Galzote C, Estanislao R, Suero MO, Khaiat A, Mangubat MI, Moideen R, et al. Characterization of facial skin of various Asian populations through visual and non-invasive instrumental evaluations: influence of age and skincare habits. Ski Res Technol. 2013;n/a-n/a. Available from:
  20. Yin L, Morita A, Tsuji T. Skin aging induced by ultraviolet exposure and tobacco smoking: evidence from epidemiological and molecular studies. Photodermatol Photoimmunol & Photomed. 2001;17(4):178–83. Available from:
  21. Asakura K, Nishiwaki Y, Milojevic A, Michikawa T, Kikuchi Y, Nakano M, et al. Lifestyle factors and visible skin aging in a population of Japanese elders. J Epidemiol. 2009/08/22. 2009;19(5):251–9. Available from:
  22. Glogau RG. Aesthetic and anatomic analysis of the aging skin. Semin Cutan Med Surg. 1996;15(3):134–8. Available from:
  23. Jusuf NK, Bachtiar A, Hadisahputra S, Soebono H. Effect of Broccoli Flower Extract (Brassica oleracea L. Var. italica Plenck) on Inhibition of Photoaging Viewed from Matrix Metalloproteinase-1 Expression in Human Skin Fibroblast. J Biol Agric Heal. 2014;4:54–60.
  24. Magdy R, Sadek A. Dermoscopic Findings of Photo-Ageing in Egyptian Patients. Egypt Dermatology Online J. 2015;11(1):1–7. Available from:
  25. Chaudhary M, Khan A, Gupta M. Skin Ageing: Pathophysiology and Current Market Treatment Approaches. Curr Aging Sci. 2020;13(1):22–30. Available from:
  26. Ahmed IA, Mikail MA, Zamakshshari N, Abdullah A-SH. Natural anti-aging skincare: role and potential. Biogerontology. 2020;21(3):293–310. Available from:
  27. Pandel R, Poljšak B, Godic A, Dahmane R. Skin photoaging and the role of antioxidants in its prevention. ISRN Dermatol. 2013;2013:930164. Available from:
  28. Vashi NA, de Castro Maymone MB, Kundu R V. Aging Differences in Ethnic Skin. J Clin Aesthet Dermatol. 2016;9(1):31–8.

How to Cite

Jusuf, N. K., Putra, I. B. ., & Muslim, M. . (2022). Evaluation of dermoscopic photoaging score among multiethnic in Medan, Indonesia. Bali Medical Journal, 11(3), 1919–1923.




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