Outcome measures in pseudofolliculitis barbae: A scoping review

Summary: Pseudofolliculitis barbae (PFB) is a dermatological condition primarily affecting the hair follicle, resulting in extrafollicular and transfollicular penetration of spiraled hair, painful papules, and potential scarring, particularly along the jawline and neck. Despite various treatment approaches used to address PFB, there is a lack of uniform grading scales and outcome measures to determine the effectiveness of treatments. We conducted a scoping review of the literature to evaluate the outcome measures used when treating PFB. MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched for a combination of keywords and database-specific controlled vocabulary terms related to PFB. The searches were conducted on December 5, 2024, and independently peer-reviewed using a modified PRESS checklist. Citations were imported into Covidence, a systematic review screening software. After the removal of duplicates, 443 studies were screened for title and abstract, and full text review was completed for 59 studies. Excluded articles lacked outcome measures, published data, correct disease indication, or were written in non-English language. Sixteen studies were included in the scoping review and demonstrated clinician and/or patient- reported outcome measures. Most physician-reported outcome measures focused on papule count, dyspigmentation and hair density reduction. Patient-reported outcome measures were centered on patient satisfaction with treatment and side effects. Only one study attempted validating the physician-reported outcomes, specifically papule and hair counts. This review highlights various grading scales and outcome measures utilized in PFB assessment. Additional effort is required in the development of a standardized global severity assessment and outcome measures for PFB to ensure the accurate assessment of treatment efficacy in future clinical trials. Jade J. Lewis¹, Adaora Okeke², Divya R. Alley³, Sarah Cantrell², Maria Hordinsky³, Tarannum Jaleel¹ 1. Dermatology, Duke Health, Durham, NC, United States. 2. Duke University School of Medicine, Durham, NC, United States. 3. Dermatology, University of Minnesota Medical School, Minneapolis, MN, United States. Minoritized Populations and Health Disparities Research