Lichen Simplex Chronicus - Causes, Symptoms & Treatment

Lichen simplex chronicus is a peculiar disorder of the skin. It is also known as Circumscribed Neurodermatitis or localized scratch dermatitis. Lichen Simplex Chronicus (LSC) is a condition created by the habitual scratching of a certain area such as the neck or legs. It can occur at any age, but it is more common in adults. Typically it appears as patches of thickened itchy skin. These thickened patches may occur anywhere on the body. Lichen Simplex Chronicus is seen in people with eczema. Although eczema can affect the whole body, the eruption of LSC in usually found in one area. The nerve endings in this area are irritable and trigger an itch-scratch-itch cycle. The more the eruption is scratched or rubbed, the more it itches, continuing the cycle. Diagnosis is by examination. A fully developed plaque has an outer zone of discrete, brownish papules and a central zone of confluent papules covered with scales. Look-alike conditions include tinea corporis, lichen planus, and psoriasis; lichen simplex chronicus can be distinguished from these by potassium hydroxide wet mount and biopsy. Primary treatment is patient education about the effects of scratching and rubbing. Secondary treatment is topical corticosteroids (eg, triamcinolone acetonide, fluocinonide ); surgical tape impregnated with flurandrenolide (applied in the morning and replaced in the evening) may be preferred because occlusion prevents scratching. Small areas may be locally infiltrated (intralesional injections) with a long-acting corticosteroid such as triamcinolone Some Trade Names acetonide 2.5 mg/mL (diluted with saline), 0.3 mL/cm 2 of lesion; treatment can be repeated q 3 to 4 wk. Oral H 1 -blocking antihistamines may be useful.

Lichen simplex chronicus is a chronic inflammation of the skin (dermatitis) characterized by small, round itchy spots that thicken and become leathery as a result of scratching. Neurodermatitis isn't serious but breaking the itch-scratch cycle can be challenging. Successful treatment depends on identifying and eliminating factors that may be aggravating the problem. Over-the-counter and prescription creams can help. Once the scratching stops, it can take months for the skin to return to normal. Lichen simplex chronicus also known as neurodermatitis circumscripta, is an itchy skin condition causing thickened skin at the areas of skin injured by repeated scratching and rubbing.  Lichen simplex chronicus is not a primary disease but rather the skin's response to chronic physical injury (trauma).  The gradual thickening of skin, caused by repetitive scratching and rubbing, is called lichenification. Lichen simplex chronicus begins as itchy skin.  Itching leads to scratching and rubbing, which causes thickening of skin.  Thickened skin is itchy, which causes more scratching and thus more skin thickening. 

Causes of Lichen Simplex Chronicus

Find common causes and risk factors of Lichen Simplex Chronicus :

• The main cause of it comes, when something that rubs, irritates, or scratches the skin, such as clothing. The thickened skin may become leathery and brownish in the affected area.
• Psychological factors play important role in the development or exacerbation of LSC.
• Long-term exposure to street traffic may be associated with an increase in the frequency of childhood skin diseases, including LSC.
• Lichen simplex chronicus may be associated with nervousness, anxiety, depression, and other psychologic disorders.
• It is common in children and mentally retarded children or who chronically scratch insect bites and other areas.

Signs and Symptoms of Lichen Simplex Chronicus

Sign and symptoms may include the following :

• Scratch marks .
• Upper eyelids .
• Opening of the ear .
• Wrists and ankles .
• Scaling .
• Skin lesion becomes leathery textured ( lichenification ) .

Treatment for Lichen Simplex Chronicus

Treatment may include :

• Corticosteroids creams may also be used over the affected area.
• Oral antianxiety medications may be used for the treatment of lichen simplex chronicus.
• Topical aspirin /dichloromethane is effective in patients with LSC who have not responded to topical corticosteroids.
• The injections of corticosteroids may be given into the affected area to reduce itching and inflammation.
• topical antibiotics like bacitracin help prevent infection. These should be used early to forestall further damage to the skin.
• Antihistamines such as diphenhydramine (Benadryl) and hydroxyzine (Atarax) are common. Doxepin (Sinequan) and clonazepam (Klonopin) may be considered in appropriate cases.

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