Disease severity scoring systems in mucosal lichen planus: A systematic review

Area of Science:

• Oral Medicine
• Dermatology
• Systematic Review

Background:

• Accurate assessment of mucosal lichen planus severity is crucial for patient management.
• Existing scoring systems for mucosal lichen planus often lack sufficient validation for reproducibility and accuracy.
• There is a need to identify and evaluate existing validated scoring systems for mucosal lichen planus.

Approach:

• A systematic bibliographic search was conducted across five databases up to October 2022.
• Studies focusing on clinical severity scoring systems for mucosal lichen planus with validity or reliability testing were included.
• Quality assessment utilized Joanna Briggs Institute Critical Appraisal tools.

Key Points:

• Eleven clinical severity scoring systems for oral lichen planus (OLP) with validity or reliability testing were identified from 118 studies.
• The Thongprasom score, Oral Disease Severity Score (ODSS), and REU (Reticular/hyperkeratotic, Erosive/erythematous, Ulcerative) scoring systems were most frequently reported for OLP.
• No validated clinical scoring systems were found for extraoral mucosal lichen planus.

Conclusions:

• The ODSS and REU scoring systems show the most validation and reliability assessments for OLP.
• Numerous factors hinder the universal adoption of a standardized scoring system for OLP.
• There is an urgent need to develop and validate scoring systems for extraoral mucosal lichen planus.