Bishnoi et al reported the Lichen Planus Activity Area and Severity Index (LPAASI) for evaluating a patient with lichen planus. The index has several subscores, one of which is the severity of nail involvement. The authors are from the Post Graduate Institute of Medical Education and Research in Chandigarh, India.
Patient selection: lichen planus
Number of nails examined: 20
Nail Changes
Points
none
0
melanonychia
1
longitudinal ridging, thinning
2
splitting of nails, pup-tent nails, onycholysis
3
pterygium
4
anonychia
5
If more than 1 change is present, then the maximum single score is counted.
total score =
= SUM(points for all of the nails)
nail score =
= (total score) / (number of nails with changes)
Interpretation:
• minimum total score: 0
• maximum total score: 100
• minimum nail score: 0
• maximum nail score: 5
• The greater the score the more severe the nail involvement
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