Clinician and Patient Perspectives in Oral Lichen Planus: Correlation and Drivers of Disease Severity and QOL

Oral lichen planus is a chronic, immune-mediated inflammatory condition that significantly impacts QOL. Clinician-reported measures, such as the Oral Disease Severity Score (ODSS), systematically evaluate clinical severity but may not adequately reflect patient experience. Patient-reported outcome measures, such as the Chronic Oral Mucosal Disease Questionnaire (COMDQ-26), provide QOL insights, although their relationship with clinical severity remains underexplored. This study aimed to assess alignment between clinician-assessed severity (measured by ODSS) and patient-reported QOL (measured by COMDQ-26) in oral lichen planus across sex and disease subtypes as well as to identify key drivers of these scores. A retrospective review of 78 patients with oral lichen planus was conducted with assessment of demographics, disease subtypes, ODSS, COMDQ-26, and pain scores. Erythematous and erosive/ulcerative subtypes had the highest severity and QOL impact scores, with no significant score differences between these subtypes. ODSS components (site, activity, pain) contributed equally to total severity, whereas the COMDQ-26 patient support domain most strongly drove QOL scores. Moderate ODSS-COMDQ-26 correlations indicated only partial alignment between clinician- and patient-reported measures. We conclude that integrating patient-reported outcome measures into clinical practice and trials may improve oral lichen planus care through more comprehensive, individualized, and subtype-focused strategies.