Assessment of itch severity and affected body surface area in classic lichen planus

Authors

  • Nadia Waqas
  • Muhammad Amer Saleem
  • Sumaira Abdullah
  • Abdul Quddus Butt
  • Sadaf Khan

Keywords:

Classic lichen planus, itch, body surface area, BSA, classic LP, LP, lichen planus

Abstract

Introduction Lichen Planus (LP) is an itchy dermatosis. It is of different types with classic LP being a common type. Itching is an important feature of disease that affects the quality of life. The study is designed to assess the severity of itch in classic LP in relation to the body surface area (BSA) involved. Materials and Methods 110 consecutive patients with classic LP who presented to Benazir Bhutto Hospital were enrolled to assess the severity of itch and its relationship to involved BSA. Severity was assessed using the Visual Analogue Scale and BSA involved was measured using hand surface area equal to 1% of total BSA. Ordinal grouping of both variables was done into three categories i.e. none/mild, moderate and severe. Statistical Analysis was done using SPSS version 23. Results Out of 110 patients, 31.8% had mild involvement, 48.2% had moderate involvement, and 20% had severe involvement in terms of affected BSA in classic LP. Severity of itch was none or mild in 15.5%, moderate in 34.5%, and severe in 50% of patients. A strong correlation between BSA involved and severity of itch was observed using Kendall’s tau-b (Tb=0.280, p=0.01) and Spearman’s test (Rs=0.307, p=0.001). Conclusion This demonstrates that Classic LP is an itchy condition with severity of itching directly proportional to BSA involved. 

References

Gutte R, Khopkar U. Predominant palmoplantar lichen planus: A diagnostic challenge. Indian J Dermatol 2014 Jul; 59 (4): 343.

Gupta SB, Chaudhari ND, Gupta A, Talanikar HV. Lichen planus–An update. Int J Pharm Biomed Sci 2013; 4 (2): 59-65.

Shiohara T, Kano Y. Lichen Planus and Lichenoid Dermatoses. In: Bolognia JL, Jorizzo J, Rapini RP, editors. Dermatology. Newyork NY, USA: Mosby Elsevier; 2008: 159-180.

Reich A, Welz- Kubiak k, Szepietowski JC. Pruritus differences between Psoriasis and Lichen Planus. Acta Dermato-Venereologica 2011; 91(5): 605-606.

Reich A, Welz-Kubiak K. The importance of pruritus in lichen planus. InActa Dermato-Venereologica 2011; 91(5): 634-635.

Balci DD, Inandi T. Dermatology life quality Index scores in Lichen Planus. Comparison of Psoriasis and healthy controls. Turkderm 2008; 42 (4): 127-130.

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19(3): 210-6.

Gelfand JM, Feldman SR, Stern RS, Thomas J, Rolstad T, Margolis DJ. Determinants of quality of life in patients with psoriasis: a study from the US population. Journal of the American Academy of Dermatology 2004; 51(5): 704-8.

Silverberg JI, Silverberg NB. Association between vitiligo extent and distribution and quality-of-life impairment. JAMA 2013; 149(2): 159-64.

Wolkenstein P, Grob JJ, Bastuji-Garin S, Ruszczynski S, Roujeau JC, Revuz J. French people and skin diseases: results of a survey using a representative sample. Arch Dermatol 2003; 139(12): 1614-1619.

Kini SP, DeLong LK, Veledar E, McKenzie-Brown AM, Schaufele M, Chen SC. The impact of pruritus on quality of life: the skin equivalent of pain. Archives of dermatology 2011; 147 (10): 1153-6.

Long CC, Finlay AY, Averill RW. The rule of hand: 4 hand areas = 2 FTU = 1 g. Arch Dermatol 1992; 128(8): 1129-30.

Kurd SK, Gelfand JM. The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003-2004. J of Am Acad of Dermatol 2009 Feb 28; 60(2): 218-24.

Reich A, Riepe C, Anastasiadou Z, Mędrek K, Augustin M, Szepietowski JC, Ständer S. Itch assessment with visual analogue scale and numerical rating scale: determination of minimal clinically important difference in chronic itch. Acta dermato-venereologica 2016; 96(7): 978-80.

Gupta S, Jawanda MK. Oral lichen planus: An update on etiology, pathogenesis, clinical presentation, diagnosis and management. Ind J Dermatol 2015; 60(3): 222.

Gupta S, Talanikar HV, Ghadgepatil S. An epidemio-clinical and histo-pathological study of lichen planus. J of Evolution of Med and Dent Sci 2016; 5(89): 6645-51.

Bhushan R, Agarwal S, Chander R, Agarwal K. Direct Immunofluorescence in Lichen Planus and Lichen Planus like Lesions. World J of Pathology 2017; 6(4).

Manolache L, Seceleanuâ€Petrescu D, Benea V. Lichen planus patients and stressful events. J of Eur Acad of Dermatol and Venereol 2008; 22(4): 437-41.

Welz-Kubiak K, Reich A, Szepietowski JC. Clinical Aspects of Itch in Lichen Planus. Acta dermato-venereologica 2017; 97(4): 505-8.

Çakmur H, Derviş E. The relationship between quality of life and the severity of psoriasis in Turkey. Eur J Dermatol 2015; 25(2): 169-76.

Edwards PC, Kelsch R. Oral lichen planus: Clinical presentation and management. J Can Dent Assoc 2002; 68: 494–9.

Ireddy SG, Udbalkar SG. Epidemiological study of lichen planus. BMR Med 2014; 1: 1-9.

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Published

2019-09-01

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