A scoring system for mucosal disease severity with special reference to oral lichen planus

Escudier, Michael; Ahmed, Nasim; Shirlaw, P J; Setterfield, Jane; Tappuni, Anwar R.; Black, Martin M.; Challacombe, Stephen

doi:10.1111/j.1365-2133.2007.08106.x

Cited by 127 publications

(158 citation statements)

References 23 publications

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“…In this study, using the scoring system for oral mucosal disease severity there were moderate to substantial levels of agreement between the two observers, and the difference between the two did not depend on the level of disease activity. Escudier's study using the scoring system for oral lichen planus measured inter-clinician variability, and showed that the reproducibility of the data was high [7].…”

Section: Discussionmentioning

confidence: 99%

“…These methods did not, however, take into account disease activity, and were therefore limited in a clinical setting [7]. They also failed to address the patientreported experience in respect of the oral discomfort, which affects quality of life in many patients affected by conditions such as oral lichen planus and MMP.…”

Section: Discussionmentioning

confidence: 99%

“…The level of agreement (k) between the three observers using the proposed system for the vertical and horizontal grade was 0.86 (p<0.001) and 0. 8 [7]. Site (a): 0 = absent, 1 = <50% of area, 2 = >50% of area.…”

Section: Interobserver Difference and Agreementmentioning

confidence: 99%

“…The lack of a universally accepted system for grading the severity of oral MMP has, however, made it difficult to undertake studies to determine which patients with oral involvement are at particular risk of ocular involvement and vice versa. Escudier et al developed a scoring system for oral mucosal disease [7], based on one previously used for MMP which included a site severity scale [8]. The modified system scores the extent of oral involvement and disease activity at each site; it also incorporates an overall pain score reported by the patient.…”

Section: Introductionmentioning

confidence: 99%

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Ocular and oral grading of mucous membrane pemphigoid

Reeves

Lloyd

Rajlawat

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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The proposed grading systems for both oral and ocular involvement in MMP are easy to use, and show good agreement between observers. The proposed ocular system correlates well with a currently used system, and overcomes some of the difficulties encountered with existing systems. For the individual patient, changes greater than 1.5 mm (vertical) and 3 mm (horizontal) are significant. This may increase our ability to detect change or disease progression. Although the risk of ocular involvement in patients with only oral involvement has been demonstrated, the severity of oral and ocular disease are not well-correlated, due in part to an absence of an ocular disease activity score.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Interobserver Difference and Agreementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ocular and oral grading of mucous membrane pemphigoid

Reeves

Lloyd

Rajlawat

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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show abstract

“…Tüm aktivite skorları toplamı oral liken planus şiddet skorunu vermektedir. Maksimum skor 72'dir 92 .…”

Section: Oral Liken Planusunclassified

Disease severity scoring systems in dermatology

Bilaç¹,

Şahin²,

Öztürkcan³

2016

TURKDERM

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Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars), alopecia (androgenetic alopecia, tractional alopecia), bullous diseases (autoimmune bullous diseases, toxic epidermal necrolysis), dermatitis (atopic dermatitis, contact dermatitis, dyshidrotic eczema), hidradenitis suppurativa, hirsutismus, connective tissue diseases (dermatomyositis, skin involvement of systemic lupus erythematosus (LE), discoid LE, scleroderma), lichen planoplaris, mastocytosis, melanocytic lesions, melasma, onychomycosis, oral lichen planus, pityriasis rosea, psoriasis (psoriasis vulgaris, psoriatic arthritis, nail psoriasis), sarcoidosis, urticaria, and vitiligo, have also been developed. Disease severity scoring methods are ever more extensively used in the field of dermatology for clinical practice to form an opinion about the prognosis by determining the disease severity; to decide on the most suitable treatment modality for the patient; to evaluate the efficacy of the applied medication; and to compare the efficiency of different treatment methods in clinical studies. Keywords: Disease severity, scoring system, dermatology Skorlama sistemleri, hastalığa ait parametrelerin değerlendirilerek hastanın klinik şiddetini objektif olarak saptama amacıyla geliştirilmiş olan ölçeklerdir. Vücut yüzey alanı, görsel analog skala ve doktor global değerlendirme skoru dermatolojik hastalıkların klinik şiddetinin değerlendirilmesi amacıyla en sık kullanılan genel skorlama sistemleridir. Bu skorlama sistemleri dışında akne (akne vulgaris, akne skarları), alopesi (androgenetik alopesi, traksiyonel alopesi), Behçet hastalığı, büllöz hastalıklar (otoimmün büllöz hastalıklar, toksik epidermal nekroliz, epidermolizis bülloza), dermatit (atopik dermatit, kontakt dermatit, dishidrotik egzama), hidradenitis suppurativa, hirsutismus, konnektif doku hastalıkları (dermatomyozit, sistemik lupus eritematozusun (LE) deri tutulumu, diskoid LE, skleroderma), liken planopilaris, mastositoz, melanositik lezyonlar-melanom, melazma, mikozis fungoides/Sezary sendromu, onikomikoz, oral liken planus, pitiriyazis rozea, psoriasis (psoriasis vulgaris, psoriatik artrit, tırnak psoriasisi), sarkoidoz, ürtiker ve anjiyoödem ve vitiligo gibi çok sayıda dermatolojik hastalık için spesifik skorlama sistemleri de geliştirilmiştir. Hastalık şiddet skorlama yöntemleri, dermatoloji alanında klinik pratikte hastalığın şiddetinin belirlenerek prognoz hakkında fikir sahibi olunabilmesi, hasta için uygun tedavinin belirlenmesi, uygulanan tedavinin etkinliğinin değerlendirilmesi, klinik araştırmalarda ise farklı tedavi yöntemlerinin etkinliklerinin karşılaştırılabilmesi gibi amaçlarla giderek d...

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Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus

Vinay,

Kumar,

Dev

et al. 2024

JAMA Dermatol

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ImportanceSymptomatic oral lichen planus (OLP) can be challenging to treat.ObjectiveTo compare the efficacy of oral acitretin plus topical triamcinolone acetonide (TAC), 0.1%, with TAC monotherapy in patients with symptomatic OLP.Design, Setting, and ParticipantsThis monocentric, investigator-initiated, placebo-controlled, investigator- and patient-blinded randomized clinical trial was conducted from December 2018 to June 2020 at the Postgraduate Institute of Medical Education and Research, a tertiary referral center in Chandigarh, India. Sixty-four patients 18 years or older with symptomatic OLP were recruited by consecutive sampling. Data were analyzed from July to December 2020.InterventionThe patients were randomized to receive either a combination of oral acitretin (25-35 mg/d) and TAC (treatment group) or TAC in combination with placebo (placebo group) for 28 weeks, with an additional 8 weeks of treatment-free follow-up after the end of treatment (36 weeks of total study duration).Main Outcomes and MeasuresThe disease severity and treatment response were assessed using Oral Disease Severity Score (ODSS), Oral Health Impact Profile 14 (OHIP-14), and visual analog scale (VAS). The primary aim was to assess the number of patients achieving ODSS-75 (75% reduction in ODSS compared with baseline) in both groups at 28 weeks and at the end of 36 weeks.ResultsAmong 64 patients, 31 in the treatment group and 30 in the placebo group completed the study (mean [SD] age, 50.6 [15.2] years vs 49.2 [14.4] years; male-female ratio, 13:19 vs 16:16). Baseline ODSS, visual analog scale, and Oral Health Impact Profile 14 scores were comparable in both groups. In the intention-to-treat analysis, there was a statistically significant higher number of patients achieving 75% or higher reduction in ODSS in the treatment group compared with the placebo group at the end of 28 weeks (28 [88%] vs 15 [47%], a 41 [95% CI, 20-61] percentage point difference between groups; P &lt; .001; Cramér V = 0.47) and 36 weeks (27 [84%] vs 13 [41%], a 43 [95% CI, 23-67] percentage point difference between groups; P &lt; .001; Cramér V = 0.47). Relapses during the posttreatment follow-up of 8 weeks were low among patients in both treatment and placebo groups (1 [3%] vs 2 [6%], a 3 [95% CI, −13 to 7] percentage point difference between groups; P &gt; .99; Cramér V = 0.07).Conclusion and RelevanceIn this randomized clinical trial, the combination of oral acitretin and TAC was more effective than TAC monotherapy in patients with symptomatic OLP.Trial RegistrationClinical Trial Registry of India Identifier: CTRI/2018/11/016448

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A scoring system for mucosal disease severity with special reference to oral lichen planus

Abstract: It is suggested that this scoring system is easy to use, reproducible and sensitive enough to detect clinical responses to therapy.

Cited by 127 publications

References 23 publications

Ocular and oral grading of mucous membrane pemphigoid

Ocular and oral grading of mucous membrane pemphigoid

Disease severity scoring systems in dermatology

Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus

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