An improved scoring system for monitoring oral lichen planus: A preliminary clinical study

To design an improved oral lichen planus (OLP) scoring system, which can be widely applied.A new scoring system that took reticulation, hyperemia and ulceration (RHU) into account, named as RHU scoring system, was designed for OLP patients' management. The patients were also scored for the reticulation/erythema/ulcer (REU) scoring system, physician global assessment (PGA), numerical rating scale (NRS) and Oral Health Impact Profile-14 (OHIP-14). The reliability and validity analyses were utilized to assess the RHU scoring system. We further applied the RHU scoring system to examine the treatment outcomes of topical dexamethasone sodium phosphate and general hydroxychloroquine hydrochloride among OLP patients.Forty-eight OLP patients from two medical centers were recruited. This new scoring system has reliability with an internal consistency index Cronbach α 0.49. The Pearson correlation of RHU score with PGA and REU score were 0.891 and 0.675 (p < 0.05) respectively, reflecting satisfactory standard validity. A 10% change in RHU score was used as the disease condition evaluation standard, reflecting satisfactory discriminating validity (t = -5.821, p < 0.001). During follow-ups, scores of all scales decreased at each re-visit. The drop between each visit of OHIP-14 fluctuated compared with the RHU system and NRS.As a semi-quantitative score system, the RHU scoring system can reflect the severity of OLP patients with hyperemia and ulceration lesions more accurately and sensitively compared with other score systems, which provides the potential to be widely used.