Validation of a Questionnaire for Self-reporting of Hyperpigmentation Disorders in Chinese-Speaking Women of Chinese Descent

D isorders of hyperpigmentation are more common in darker-skinned individuals such as the Chinese. A few studies have been performed in dermatology clinics attempting to determine the prevalence of lentigines, postinflammatory hyperpigmentation (PIH), and melasma. However, the prevalence of these conditions in most populations is unknown. The goal of the present study was to develop and validate a questionnaire for self-reporting of hyperpigmentation disorders in Chinese women. Methods. A series of questions was first developed in English and then translated into Chinese. Some questions were reworded based on the rules of Chinese syntax. The resulting translations were reviewed by a panel of Chinese teachers for accuracy and comprehensibility. After approval was obtained from the institutional review board, an initial test with a focus group was carried out with a group of 6 Chinese women aged 18 to 55 years. They were sampled randomly from the waiting room of a Chinese-speaking primarycarephysician.Onlywomenwerechosen for this study because disorders of hyperpigmentation in Asians, such as melasma, are more common in women. Furthermore, in our experience, women are more concerned about facial disorders of hyperpigmentation than men. After obtaining feedback from the focus group, we evaluated the questions and altered them to improve comprehension. These were then back-translated to English and then reviewed by one of us (A.G.P.), who confirmed that the meaning of the original English question was not lost (Figure 1). The questionnaire was then administered to women at the 2006 Chinese Health Fair in Houston, Texas. After they completed the questionnaire, the women were examined individually for the presence or absence of melasma, lentigines, and PIH by an examiner experienced in the diagnosis of these disorders. The examiner was blinded to the results of the questionnaire at the time of the examination. All patients in the focus group as well as those at the health fair gave written informed consent prior to participation.