Vestnik dermatologii i venerologiiVestnik dermatologii i venerologii0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov114510.25208/vdv1145Research ArticleA new index to assess the severity of Lichen planus in clinical practicePatrushevAleksandr V.<p>Senior Lecturer at the Department of Skin and Venereal Diseases of the Federal State Budgetary Educational Institution of Higher Education "Military Medical Academy named after C.M. Kirov" Ministry of Education of the Russian Federation, Candidate of Medical sciences</p>alexpat2@yandex.ruSamtsovAleksei V.<p>Doctor of Medical Sciences, Professor, Professor at the Department of Skin and Venereal Diseases of the Federal State Budgetary Educational Institution of Higher Education "Military Medical Academy named after C.M. Kirov" Ministry of Education of the Russian Federation</p>avsamtsov@mail.ruSukharevAleksei V.<p>Doctor of Medical Sciences, Professor, Professor at the Department of Skin and Venereal Diseases of the Federal State Budgetary Educational Institution of Higher Education "Military Medical Academy named after C.M. Kirov" Ministry of Education of the Russian Federation</p>asoukharev@mail.ruMinchenkoAleksandr A.<p>Head of the Mycological Office at the Clinic of Skin and Venereal Diseases of the Federal State Budgetary Educational Institution of Higher Education "Military Medical Academy named after C.M. Kirov" Ministry of Education of the Russian Federation</p>minchenkoaleksandr@yandex.ruMamunovMaxim V.<p>5th year student of the Faculty of Training Doctors for the Rocket, Ground and Airborne Forces, majoring in "general medicine" at the Federal State Budgetary Educational Institution of Higher Education "Military Medical Academy named after C.M. Kirov" Ministry of Education of the Russian Federation</p>23vf@mail.ruFederal state budgetary educational institution of higher military education “Military Medical Academy named after S.M. Kirov” of the Russian Ministry of Defense2909202096327330906202018062020Copyright © 2020, Patrushev A.V., Samtsov A.V., Sukharev A.V., Minchenko A.A., Mamunov M.V.2020<p><strong>Purpose.</strong>Development and validation of the severity index of lichen planus (LP).</p>
<p><strong>Materials and methods.</strong>At the first stage, by means of theoretical substantiation, the main parameters and signs were identified that affect the severity of the disease and the quality of life of patients, which culminated in the derivation of the final index formula, which was called the lichen area and severity index (LPASI). At the second stage, LPASI was validated during the examination of 45 LP patients who were treated in the clinic of skin and venereal diseases of the Military Medical Academy in 20182019. Determination of LPASI was carried out by five dermatovenerologists independently of each other twice with an interval of one week.</p>
<p>The analysis of the results was carried out using STATISTICA 10.0 programs and SPSS Statistics 17.0. The Spearman Brown and Pearson correlation coefficients were used to evaluate the intra-expert and inter-expert reliability of the index, and the Cronbach's alpha coefficient was calculated to assess the internal consistency of the scale.</p>
<p><strong>Results.</strong>The final formula for calculating LPASI is as follows: 0.2A+2B+5С+D, where A is the area of skin lesions in percentage, B is the severity of clinical manifestations on the skin, C is the severity of clinical manifestations on the oral mucosa and D is the severity of subjective sensations. The index can range from 0 to 82.</p>
<p>The LPASI values for the whole group (<em>n</em>=45) were characterized by a normal distribution of the trait (<em>p</em>0.05), the minimum and maximum values varied from 7.2 to 42 points, the median was 22 points, the interquartile span from 14 to 27 points. The values of the Spearman Brown and Pearson coefficients were equal to 0.91 (95% CI 0.890.99) and 0,87 (95% CI 0.860.93), which indicates the reproducibility of the results and the reliability of the index. In this case, a high consistency between the selected features within the scale (Cronbach's alpha criterion 0.93) was established.</p>
<p><strong>Conclusion.</strong>Objectification of the severity of the disease using LPASI should become an integral part of the clinical examination of patients. The use of LPASI will allow to control the effectiveness of prescribed therapy, as well as to compare the results of scientific research.</p>lichen planusprevalence and severity indexlichen planus area and severity indexLPASIvalidationreliabilityquality of lifeплоский лишайкрасный плоский лишайиндекс распространенности и тяжести теченияИРТПЛвалидациянадежностькачество жизни[Самцов А.В., Барбинов В.В. Дерматовенерология. М.: ГЭОТАР-Медиа, 2016. [Samcov A.V., Barbinov V.V. Dermatovenerology. M.: GEOTAR-Media, 2016 (Russia).]][Usatine R.P. Diagnosis and Treatment of Lichen Planus. Am Fam Physician. 2011; 1 (84): 53—60.][Питтелков М.Р., Даоуд М.С. Красный плоский лишай. В кн.: Дерматология Фицпатрика в клинической практике: в 3 т. / Пер. с англ.; общ. ред. акад. А.А. Кубановой. М.: Издательство Панфилова; БИНОМ. Лаборатория знаний, 2012. Т. 1: C. 264—277. [Pittelkov M.R., Daoud M.S. Lichen ruber planus. V: Dermatologiya Fitspatrika v klinicheskoi praktike: 3 v. Trans. with English; Ed. Acad. A.A. Kubanova. Moscow: Izdatel'stvo Panfilova; BINOM. Laboratorija znanij, 2012. V. I: P. 264—277 (Russia).]][Кубанова А.А., Кубанов А.А., Олисова О.О., Чикин В.В., Минее¬ва А.А. Красный плоский лишай. В кн.: Федеральные клинические рекомендации. Дерматовенерология, 2015: Болезни кожи. Инфекции, передаваемые половым путем. 5-е изд., перераб. и доп. М.: Деловой экспресс, 2016: 212—225. [Kubanova A.A., Kubanov A.A., Olisova O.O., CHikin V.V., Mineeva A.A. Lichen ruber planus. In: Federal Clinical Recommendations. Dermatovenerology, 2015: Skin diseases. Sexually transmitted infections. 5th ed., rev. and add. Moscow: Delovoy Ekspress, 2016: 212—225 (Russia).]][Weston G., Payette М. Update on lichen planus and its clinical variants. Int J Womens Dermatol. 2015; 1 (3): 140—149.][Shengyuan L., Songpo Y., Wen W. et al. Hepatitis C virus and lichen planus: a reciprocal association determined by a meta-analysis. Arch Dermatol. 2009; 145 (9): 1040—1047.][Usatine R.P., Tinitigan M. Diagnosis and Treatment of Lichen Planus. Am Fam Physician. 2011; 1 (84): 53—60.][Georgescu S.R., Tampa M., Mitran M.I. et al. Potential pathogenic mechanisms involved in the association between lichen planus and hepatitis C virus infection. Exp Ther Med. 2019; 17 (2): 1045—1051.][Giannetti L., Dello Diago A.M., Spinas E. Oral Lichen planus. J Biol Regul Homeost Agents. 2018; 32 (2): 391—395.][Halevy S., Shai A. Lichenoid drug eruptions J Am Acad Dermatol. 1993; 29 (1): 249—255.][Патрушев А.В., Самцов А.В., Никитин В.Ю. и др. Клинико-лабораторные особенности при хронических дерматозах у военнослужащих. Воен.-мед. журн. 2019; 360 (1): 25—33. [Patrushev A.V., Samcov A.V., Nikitin V.YU. i dr. Clinical and laboratory features in chronic dermatoses in servicemen. Voen.-med. zhurn. 2019; 360 (1): 25—33 (Russia).]][Адаскевич В.П. Диагностические индексы в дерматологии. М.: Издательство Панфилова; БИНОМ. Лаборатория знаний, 2014. [Adaskevich V.P. Diagnostic indices in dermatology. M.: Izdatel'stvo Panfilova; BINOM. Laboratoriya znanij, 2014 (Russia).]]