Changes in the Oral-Health-Related Quality of Life of Thai patients with oral lichen planus after topical corticosteroid treatment: a 1-month longitudinal study
Authors: Kengtong Witchapat , Piboonratanakit Pornpan , Krisdapong Sudaduang 
Published: August 2023

Background
Oral lichen planus (OLP) is a common chronic inflammatory disease of the oral cavity that affects many patients’ daily living activities. The goal of treating OLP is to relieve symptomatic pain, and reduce inflammation. Topical corticosteroids are the first-line drug for treating OLP. OLP clinical trials should use a tripartite approach comprising clinical signs, symptoms, and quality of life. The Oral Impact on Daily Performances index (OIDP) is an Oral-Health-Related Quality of Life (OHRQoL) measure developed to assess the ultimate impacts. The aims of this study were to evaluate the clinical, pain and OHRQoL responses after treating OLP patients with topical corticosteroids for 1 month, and secondly to assess the relationships of changes in the clinical sign score, pain score, and OHRQoL.
Methods
Seventy-two OLP patients were recruited to assess their clinical outcomes and patient-based outcomes after treating them with topical corticosteroids for 1 month. The clinical outcomes were evaluated by the highest and total Thongprasom sign score. The patient-based outcomes were evaluated by a pain rating scale using a numeric rating scale (NRS), and OIDP. The self-rated overall changes in quality of life during the 1-month treatment period using the Patient Global Impression of Change (PGIC) were also recorded at the follow-up visit.
Results
This study comprised 59 women (81.9%) and 13 men (18.1%). The total OIDP percentage score was 19.1 ± 10.5 at baseline. The most commonly affected activities were Emotional stability (94.4%), followed by Eating (86.1%) and Cleaning the oral cavity (65.3%). At the 1-month follow-up visit, the highest Thongprasom sign score, total Thongprasom sign score, pain score and total OIDP percentage score were significantly reduced after treatment with topical corticosteroids (P < 0.01). None of the patients reported a lower quality of life. Forty-six percent reported the same or up to moderately improved, while 54% had a greatly improved quality of life as assessed by PGIC. There were no significant differences in the improvement of clinical and patient-based outcomes between these outcome groups. There were significant relationships between the difference in the highest Thongprasom sign score and the difference in total Thongprasom sign score (r = 0.293; P < 0.05), and the differences in total OIDP percentage score and the difference in pain score (r = 0.427; P < 0.001). The differences in the total Thongprasom sign score also significantly related to the difference in the total OIDP percentage score (r = 0.335; P < 0.01). However, no significant relationship was found between the difference in the highest Thongprasom sign score and the difference in patient-based outcomes.
Conclusion
Topical corticosteroids were significantly effective after 1-month treatment of OLP based on the clinical and patient-based outcomes. The OHRQoL improvement was significantly related to the reductions in pain and clinical severity.
Trial registration
The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR 20221110001).