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

Objectives
Several scoring systems have been developed to evaluate disease severity in mucosal lichen planus, but only a few have been validated to ensure reproducible and accurate assessment of disease severity. The current systematic review was undertaken to identify clinical severity scoring systems in mucosal lichen planus that have undergone validity or reliability testing and
to describe their operating characteristics.
Materials and Methods
We performed a bibliographic search in five databases from their inception to October 2022 for severity scoring systems in mucosal lichen planus that have undergone validity or reliability tests. Quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal
tools.
Results
We have included 118 studies and identified 11 clinical severity scoring systems for oral lichen planus that have undergone validity or reliability testing. Of these, the most reported were the Thongprasom score, the Oral Disease Severity Score (ODSS) and the REU (Reticular/hyperkeratotic, Erosive/erythematous, Ulcerative) system. We did not identify clinical scoring systems for extraoral mucosal lichen planus that have undergone validity or reliability testing.
Conclusion
The ODSS and REU scoring systems have undergone the highest number of validation attempts and reliability assessments for oral lichen planus, respectively. However, numerous factors that have hampered the development of a standardised scoring system were identified. There is a need for the development and validation of scoring systems for extraoral mucosal lichen planus.