Lichen Simplex Chronicus

Last reviewed by Dr.Mary on August 7th, 2018.

What is Lichen Simplex Chronicus?

This is a condition of the skin categorized by scaling as well as chronic itching. It begins with an area of skin that is itchy. Scratching will only make the region even itchier so an individual must keep from scratching. Ultimately the individual will scratch out of habit. This phase of chronic itching and scratching usually makes the skin that is affected become leathery and thick.


Lichen simplex chronicus is also referred to as neurodermatitis or scratch dermatitis and is not serious, but the challenge becomes breaking the cycle of itch-scratch-itch. Any treatment to be successful in the healing of lichen simplex chronicus depends on the identification and elimination of factors that can be the reason for the problem. Prescription as well as over the counter creams may aid in easing the symptoms of lichen simplex chronicus. Once the cycle of itching and scratching is broken, it may take some time for the skin to become normal again.

Lichen Simplex Chronicus Symptoms

Symptoms and signs of lichen simplex chronicus consist of:

  • Skin in a limited, single area that is itchy
  • Scaly or leathery texture to the skin
  • Rough, raised area that is darker or redder than the remainder of the skin

The symptom of lichen simplex chronicus that is primary is skin that is itchy – often in a single area or patch on the forearm, neck, thigh, ankle, or wrist. Often this condition affects the areas of the genitals, for instance scrotum or vulva

The intense itchiness comes and goes. Ultimately you may simply scratch out of habit.

Anyone with this condition should see their physician if:

  • Catch themselves scratching the same area of skin repeatedly
  • Are so uncomfortable that they are losing sleep
  • Are so uncomfortable they are kept from daily routines
  • The skin is painful
  • Believe the skin is infected. Infection signs include thick, yellowish fluid draining from the areas scratched and pain

Lichen Simplex Chronicus Causes

The exact cause of this condition is not known. Often lichen simplex chronicus starts with anything that can trigger the itch response or irritates the skin, for example clothes that are tight or a bite from a bug. The more it is rubbed or scratched, the itchier the area gets.

In several cases, lichen simplex chronicus is linked with other conditions of the skin such as eczema, dry skin or psoriasis. Anxiety and stress can also trigger this itching.

Some factors can increase a person’s risk of lichen simplex chronicus, and they consist of:

  • Being mid-aged – This condition is mostly common between the ages of thirty and fifty.
  • Being a woman – Women are normally affected most often than are men.
  • History of skin conditions – Individuals with a family or personal history of psoriasis, eczema or similar type conditions of the skin are most likely to have this condition.

Any persistent scratching or irritation can lead to skin infections caused by bacterial as well as scars or changes in the color of the skin that are permanent. Not to mention that scratching can in some case interrupt sleeping at night.

Lichen Simplex Chronicus Treatment

The diagnosis is normally founded on the appearance of the skin and any past of scratching and itching. The physician can recommend 1 of the below tests in order to exclude other reasons or to be a confirmation of the conclusion.

Patch testing

The patch test can exclude certain other reasons for itchy skin, for instance allergic contact dermatitis. With a patch test, tiny quantities of allergens which are potential are placed to tiny patches then placed on the skin. These patches stay on the skin for at least 2 days and then the physician will check for any reaction. If the individual is allergic to a certain substance that is being tested, there will be a bump that is raised or some type of reaction to the skin just underneath the patch.

Punch biopsy

With a punch biopsy test, the physician uses a circular tool to remove a small section of the skin’s deeper layers. You can receive stitches in order to close any wound. Biopsies may exclude some conditions, for instance lichen planus that can mimic lichen simplex chronicus.

The treatment of this condition first must interrupt the itch-scratch cycle and needs to begin with stopping scratching the area that is affected.

The physician can advise 1 or more of the following treatments:

Medications that are prescription

Topical or oral corticosteroids as well as oral antihistamines can be necessary to reduce any inflammation as well as relieving any intense itching. Anti-anxiety or antidepressants can help some people. If a bacterial infection develops in the rash, the physician can also prescribe an antibiotic lotion or oral therapy.

Dressings that are wet

This comprises applying medicated cream to affected regions and then covering these areas with cotton material that is damped from being soaked in solutions or water. The moisture in any dressings that is wet aids the skin in absorbing the medicated cream. Covering the region with tape that is plastic and contains medication in the adhesive or tape applied over the skin with corticosteroid ointment or cream may also aid the areas. The tape needs to be changed every 24 hours, or at intervals the doctor recommends.

Counseling

A counselor also can help any individual learn about emotions and behaviors that can fuel – or prevent – scratching or itching.

Punch biopsy

A punch biopsy is a test using a circular tool to remove a small section of the skin’s deeper layers. Stitches are used to close this wound. The biopsy can then exclude other skin conditions, such as lichen planus or others that are similar to lichen simplex chronicus.

Lichen Simplex Chronicus Cure

  • Lesions may clear completely
  • Pruritus can resolve but mild scarring and changes in pigmentation remain even after treatment is successful.
  • Relapse is most likely when individual is under periods of stress or if previously affected area of skin is stressed by heat or humidity extremes or skin allergens or irritants.
  • Patients who don’t comply with any treatment regimen as well as cessation of scratching, lesions will not get better.

Lichen Simplex Chronicus Pictures

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