ArticleJournal of cosmetic dermatology2026
The PharmaResearch Under Eyelid Fine Line Severity Scale: Development and Validation of a Standardized Clinical Assessment Tool for Infraorbital Fine Wrinkles.
Article in Journal of cosmetic dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Development and Validation of the Cheek Smoothness Scale: A Photonumeric Assessment Tool for Cheek Skin Texture.Journal of cosmetic dermatology · 2026Article
- The PharmaResearch Under Eyelid Fine Line Severity Scale: Development and Validation of a Standardized Clinical Assessment Tool for Infraorbital Fine Wrinkles.Journal of cosmetic dermatology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
backgroundFine lines under the lower eyelid are among the earliest and most prominent signs of facial aging. However, despite growing interest in noninvasive aesthetic procedures targeting this area, there is currently no validated clinical scale specifically designed to assess the severity of infraorbital fine lines. Furthermore, existing assessment tools-such as those for lateral canthal lines or infraorbital hollowing-fail to adequately capture the unique characteristics of horizontally oriented fine wrinkles in this region.
aimsTo develop and validate a novel photonumeric clinical grading tool, called the PharmaResearch Under Eyelid Fine Line Severity (PULS) scale, for the standardized assessment of infraorbital fine lines.
methodsA total of 53 healthy adults without facial dermatologic conditions were photographed under standardized conditions. From the resulting image set, 73 photographs (53 unique and 20 duplicate images) were selected. Five board-certified dermatologists used our newly developed 5-grade photonumeric scale to independently evaluate the severity of infraorbital fine lines. Inter- and intra-rater reliability was assessed using Fleiss' and Cohen's Kappa, respectively. Agreement rates were also calculated.
resultsInter-rater reliability analysis yielded a Fleiss' Kappa of 0.6114, indicating good inter-rater agreement. All raters showed perfect intra-rater reliability, with Cohen's Kappa values of 1.0000. The overall agreement rate across all evaluations exceeded 80%, supporting the reproducibility and consistency of the PULS scale.
conclusionsThe PULS scale is a validated, reliable, and practical photonumeric grading tool that can address an unmet need in aesthetic dermatology by facilitating standardized evaluation of treatment outcomes for infraorbital fine lines in both clinical research and routine practice.
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