European Journal of Dermatology

, Volume 27, Issue 6, pp 615–619 | Cite as

Clinical assessment of skin phototypes: watch your words!

  • Myrto Trakatelli
  • Matilda Bylaite-Bucinskiene
  • Osvaldo Correia
  • Antonio Cozzio
  • Esther De Vries
  • Ljiljana Medenica
  • Eduardo Nagore
  • John Paoli
  • Alexander J. Stratigos
  • Véronique Del Marmol
  • Jean-Luc BulliardEmail author
Clinical report



Fitzpatrick skin phototype classification is widely used to assess risk factors for skin cancers. This skin type evaluation is easy to use in clinical practice but is not always applied as initially described, nor practiced in a standardisedway. This can have implications on the results of relevant dermato-epidemiological studies.


To demonstrate, in a large multinational setting, that the phrasing of questions on sun sensitivity can have a strong impact on the perception and reporting of skin phototype, as well as the importance of a standardised procedure for phototype assessment.

Materials & methods

Using data collected from 48,258 screenees of the Euromelanoma campaign in six European countries from 2009 to 2011, we analysed the impact of change in the question phrasing on phototype classification in each country.


Changing the wording of a question to assess the phototype of a person also significantly influenced the classification of phototypes in different countries (p<0.001 for each country). The difference essentially corresponded to a shift towards a less sun-sensitive skin type when a shorter question that did not include skin colour description was used. The only exception was Portugal where phototype was not patient-assessed and classification shifted towards a more sun-sensitive phototype. Results were statistically significant and highly consistent, irrespective of gender.


The phrasing of questions on skin type is important and substantially influences reporting. A standardized procedure to classify phototypes should be used in order to obtain comparable data between studies.

Key words

Fitzpatrick skin phototype classification question phrasing sun sensitivity wording country standardised procedure 


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Copyright information

© JLE/Springer 2018

Authors and Affiliations

  • Myrto Trakatelli
    • 1
    • 2
  • Matilda Bylaite-Bucinskiene
    • 3
  • Osvaldo Correia
    • 4
  • Antonio Cozzio
    • 5
  • Esther De Vries
    • 6
  • Ljiljana Medenica
    • 7
  • Eduardo Nagore
    • 8
  • John Paoli
    • 9
  • Alexander J. Stratigos
    • 10
  • Véronique Del Marmol
    • 11
  • Jean-Luc Bulliard
    • 12
    Email author
  1. 1.Second Department of Dermatology and VenereologyAristotle University, Papageorgiou HospitalThessalonikiGreece
  2. 2.Department of DermatologySt.Pierre HospitalBrusselsBelgium
  3. 3.Centre of DermatologyVilnius UniversityVilniusLithuania
  4. 4.Centro Dermatologia EpidermisInstituto CUF and Faculty of Medicine of University of PortoPortoPortugal
  5. 5.Department of DermatologyUniversity Hospital ZurichZurichSwitzerland
  6. 6.Department of Clinical Epidemiology and BiostatisticsPontificia Universidad JaverianaBogotaColombia
  7. 7.Department of Dermatology, University of Belgrade, School of Medicine, Clinic of DermatovenereologyClinical Centre of SerbiaBelgradeSerbia
  8. 8.Department of DermatologyInstituto Valenciano de OncologiaValenciaSpain
  9. 9.Department of Dermatology, Institute of Clinical Sciences at the Sahlgrenska AcademyUniversity of Gothenburg, Sahlgrenska University HospitalGothenburgSweden
  10. 10.1st Department of Dermatology-VenereologyNational and Kapodistrian University of Athens School of Medicine, Andreas Sygros HospitalAthensGreece
  11. 11.Department of DermatologyHôpital Erasme, Université Libre de BruxellesBrusselsBelgium
  12. 12.Division of Chronic DiseasesUniversity Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois (CHUV) and University of LausanneLausanneSwitzerland

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