Protocol for the development of a core outcome domain set in cutaneous lichen planus

Lichen planus (LP) is a chronic inflammatory condition that affects the skin, nails, and mucous membranes. Cutaneous LP typically presents with itchy, flat-topped, violaceous papules. LP can significantly affect quality of life due to visible disfigurement, persistent itching, or pain. Evidence on treatment efficacy is limited and difficult to compare due to heterogeneity of outcome domains and instruments. Core Outcome Sets (COS) offer a structured solution to inconsistent outcome selection. No COS currently exists for LP. Given the variability in outcomes and the emerging therapies for LP, a COS is urgently needed to improve outcomes and comparability between future studies. The Lichen planus Core Outcome Set (LiCOS) initiative is an international collaboration involving dermatologists and patient partners whose goal is to achieve consensus among expert dermatologists on a core set of outcome domains for the assessment of cutaneous LP in clinical trials.

Potentially Relevant COS:
The COS for oral lichen planus does not fully cover this domain as patients can have oral lichen planus with or without cutaneous symptoms. Furthermore, the core domains identified and survey questions do not pertain to cutaneous involvement, making the proposed LiCOS study unique.


Contributors

Amit Garg (Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell)
Sanne Uitentuis (Department of Dermatology Amsterdam Public Health/Infection and Immunology, Amsterdam UMC)

Further Study Information

Current Stage: Ongoing
Date: October 2026 - April 2027
Funding source(s): None


Health Area

Disease Category: Skin

Disease Name: Cutaneous lichen planus

Target Population

Age Range: 18 - 100

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Clinical experts
- Patient/ support group representatives
- Researchers

Study Type

- COS for clinical trials or clinical research

Method(s)

- Consensus meeting
- Delphi process
- Literature review
- Survey

An international steering group will guide the CDS development. Two stakeholder groups are involved: patients and dermatologists. The initial list of candidate items will be obtained by combining the following datasets: (1) a scoping review of the literature, (2) an online survey of patients and dermatologists to generate candidate domains of interest. To reach consensus on the COS, a minimum of 2 anonymous Delphi rounds are planned together with virtual consensus meetings to ensure global representation.

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