Lichen Planus Severity Index: A new, valid scoring system to assess the severity of cutaneous lichen planus

Kaur, Harsimran; Nikam, Balkrishna P; Jamale, Varsha; Kale, Mohan

doi:10.4103/ijdvl.ijdvl_650_17

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…They observed high reproducibility with respect to LP severity index between the two groups of clinicians and dermatopathologists (consensus group and primary reproducibility group). They also observed positive correlation between LP severity score and physical global assessment score for cutaneous LP 11 . However, they did not include any histopathological parameter for evaluating the disease activity.…”

Section: Discussionmentioning

confidence: 97%

Introducing a novel histopathological scoring system to assess disease activity and chronicity in cutaneous lichen planus: A proposal

Dixit

Jain

et al. 2023

J Cutan Pathol

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Background: Lichen planus (LP) is a chronic inflammatory disorder caused by an autoimmune attack by cytotoxic T-cells. The clinical course is variable, with episodes of remission and exacerbation. A clinicopathological scoring system for cutaneous LP is not available for effectively assessing disease severity and monitoring treatment response. This study was designed with the aim of proposing an objective and reproducible scoring system, comprising histopathological features of active and chronic disease, and to correlate these scores with clinical morphology groups. Methodology: This is a retrospective study of 200 cases of cutaneous LP, which were categorized into five clinical groups (I-V) at the time of biopsy. The corresponding histopathological feature was assigned a score based on feature of active and chronic disease. Individual scores were summated to calculate a histopathological index (index [AI] and chronicity index [CI]). The comparison of indices between various clinical groups was performed by Mann-Whitney U test.Results: The median AI was lowest (1) for post-inflammatory hyperpigmentation (clinical group I) and highest (7) for the bullous group (clinical group IV). The median CI (7) was highest for the scarring group (clinical group V). The difference between median AI of clinical group I (post-inflammatory hyperpigmentation) and rest of the groups (clinical groups II, III, IV, and V) was statistically significant (p value <0.05). Conclusion:We present this clinico-histopathological scoring system as a reliable and facile method of assessing the activity and severity of LP.

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Section: Discussionmentioning

confidence: 97%

Introducing a novel histopathological scoring system to assess disease activity and chronicity in cutaneous lichen planus: A proposal

Dixit

Jain

et al. 2023

J Cutan Pathol

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“…To determine lichen planus severity, the counting of total number of lesions and assessing the percentage of each of the morphological types (erythematous papules, violaceous papules, violaceous plaques, hyperpigmented hypertrophic papules and plaques, and post-inflammatory hyperpigmentation) is needed, followed by assignment of the area involvement factor. The final scoring requires multiplication with the multiplying factors for each respective lesion type and the total BSA factor [ 22 ]. It has to be mentioned that both scales are quite complicated, time consuming, and difficult for implementation in routine daily practice, and only LPSI has been validated to some extend so far [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…The final scoring requires multiplication with the multiplying factors for each respective lesion type and the total BSA factor [ 22 ]. It has to be mentioned that both scales are quite complicated, time consuming, and difficult for implementation in routine daily practice, and only LPSI has been validated to some extend so far [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Lichen Planus Activity and Damage Index (LiPADI)–Creation of the Questionnaire

Stępień

Żabska

Rahnama-Hezavah

et al. 2021

JCM

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Introduction: Lichen planus (LP) is a chronic autoimmune disease that affects skin, oral and genital mucosa, and other sites. Basic difficulties in assessment of LP are multitude of disease forms and diverse locations of lesions. Moreover, there is lack of objective and consolidated tool for assessment of disease severity and LP progression. Objective: The aim of the study was to develop a valid evaluation tool of LP severity, which will enable disease assessment in a repetitive way. Materials and methods: A combined tool called Lichen Planus Activity and Damage Index (LiPADI) was developed to assess the severity of LP skin, mucosal, and nail lesions as well as hair loss/scaring alopecia to provide an integrative scoring for LP activity and damage caused by the disease. Skin lesions were assessed in nine locations: scalp, face, chest, abdomen, back and buttocks, arms, hands, legs, and feet. The assessment of lesion activity included erythema, hypertrophy, and scaling, while the damage was reflected by the assessment of hyperpigmentation and scaring/atrophy. In addition, mucosal lesions, nail abnormalities, hair loss, and scarring alopecia were evaluated as well. LiPADI scoring was compared with quality of life assessed with the Dermatology Life Quality Index, EQ-5D calculator, pain and pruritus intensity assessed with the Numerical Rating Scale as well as with the patient and physician global assessment. Results: Our results show that LiPADI well reflects the LP patient’s clinical condition. The obtained results were in line with other indicators assessed. In addition, it was possible to evaluate patients with various forms and locations of LP, what indicates its versatility. Conclusions: LiPADI seems to be a useful tool for measurement the severity of the LP and its progress over time, which could help to monitor the effectiveness of the patients’ treatment.

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“…His clinical examination revealed multiple pigmented plaques over his body surface, without any oral mucosal and appendageal involvement ( Figures 1 A and B ). His disease severity score evaluated by Lichen Planus Severity Index (LPSI) was 32 [ 4 ]. All routine laboratory tests on blood cell analysis and liver and kidney functions were within their respective normal ranges.…”

mentioning

confidence: 99%

Successful treatment of childhood lichen planus with upadacitinib

Yu,

Wu,

Chen

et al. 2024

pdia

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Lichen Planus Severity Index: A new, valid scoring system to assess the severity of cutaneous lichen planus

Cited by 14 publications

References 6 publications

Introducing a novel histopathological scoring system to assess disease activity and chronicity in cutaneous lichen planus: A proposal

Introducing a novel histopathological scoring system to assess disease activity and chronicity in cutaneous lichen planus: A proposal

Lichen Planus Activity and Damage Index (LiPADI)–Creation of the Questionnaire

Successful treatment of childhood lichen planus with upadacitinib

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