Ormond et al described using the Oral Disease Severity Score (ODSS) for evaluating a patient with oral pemphigus vulgaris. The authors are from Guy's and St Thomas' NHS Foundation, King's College, Birmingham Dental Hospital, Eastman Dental Hospital, University College London and University Dental Hospital Manchester.
Patient selection: oral pemphigus vulgaris
Score components:
(1) sites involved
(2) activity at sites involved
(3) pain
Sites:
(1) outer lips (1 if present)
(2) inner lips (1 if present)
(3) right buccal mucosa (1 if 1-49%; 2 if >= 50%)
(4) left buccal mucosa (1 if 1-49%; 2 if >= 50%)
(5) gingiva lower right (1 if present)
(6) gingiva lower central (1 if present)
(7) gingiva lower left (1 if present)
(8) gingiva upper right (1 if present)
(9) gingiva upper central (1 if present)
(10) gingiva upper left (1 if present)
(11) dorsum of tongue (1 if unilateral; 2 if bilateral
(12) right ventral tongue (1 if present)
(13) left ventral tongue (1 if present)
(14) floor of mouth (1 if unilateral; 2 if bilateral)
(15) hard palate (1 if unilateral; 2 if bilateral)
(16) soft palate (1 if unilateral; 2 if bilateral)
(17) oropharynx (1 if unilateral; 2 if bilateral)
where:
• The central gingiva goes from canine to canine.
subscore for site =
= SUM(points for all of the sites)
Activity
|
Activity
|
Points
|
|
none
|
0
|
|
mild erythema or white healing lesion
|
1
|
|
marked erythema without erosion
|
2
|
|
erosion or ulceration
|
3
|
subscore for site =
= SUM((site * activity score) for all of the sites)
Pain
VAS from 0 to 10 (0 no discomfort; 10 extreme pain)
total score =
= (subscore for sites) + (subscore for activity) + (subscore for pain)
Interpretation:
• maximum site subscore: 24
• maximum activity subscore: 72
• maximum total score: 106
