Singer et al developed a scale to describe the histologic appearance of a burn scar. The authors are from the State University of New York at Stony Brook.
The skin biopsy was taken 90 days after the burn and taken down to the subcutaneous fat (full thickness).
Parameters:
(1) hyperkeratosis
(2) epidermal hyperplasia (acanthosis)
(3) hair follicles
(4) apocrine glands
(5) smooth muscle cells
(6) collagen in the dermis
(7) fibroplasias
(8) vascular proliferation
|
Parameter |
Finding |
Points |
|
hyperkeratosis |
no |
1 |
|
|
yes |
0 |
|
epidermal hyperplasia |
no |
1 |
|
|
yes |
0 |
|
hair follicles |
present |
1 |
|
|
absent |
0 |
|
apocrine glands |
absent |
0 |
|
|
present |
1 |
|
smooth muscle cells |
absent |
0 |
|
|
present |
1 |
|
collagen in the dermis |
none |
3 |
|
|
limited to the papillary dermis |
2 |
|
|
extends to upper half of reticular dermis |
1 |
|
|
extends into the lower half of the reticular dermis (full thickness) |
0 |
|
fibroplasias |
no |
1 |
|
|
yes |
0 |
|
vascular proliferation |
no |
1 |
|
|
yes |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the better the outcome. A score of 0 represents the most severe burn.
Specialty: Emergency Medicine, Critical Care
