Lichen simplex chronicus

Template:Short description Template:Infobox medical condition (new) Lichen simplex chronicus (LSC) is thick leathery skin with exaggerated skin markings caused by sudden itching and excessive rubbing and scratching.<ref name=Andrew2020>Template:Cite book</ref> It generally results in small bumps, patches, scratch marks and scale.<ref name=Andrew2020/> It typically affects the neck, scalp, upper eyelids, ears, palms, soles, ankles, wrists, genital areas and bottom.<ref name=Andrew2020/> It often develops gradually and the scratching becomes a habit.<ref name=Andrew2020/>

Signs and symptoms

People burdened with LSC report pruritus, followed by uncontrollable scratching of the same body region, excessively.<ref name=":0">Template:Cite journal</ref> Most common sites of LSC are the sides of the neck, the scalp, ankles, vulva, pubis, scrotum, and extensor sides of the forearms.<ref name=":1" /> However, due to the stigma associated with chronic scratching, some patients will not admit to chronic rubbing or abrasion. The skin may become thickened and hyperpigmented (lichenified) as a direct result of chronic excoriation.<ref name=":1" /> Typically this period of increased scratching is associated with stressors.

Causes

This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:<ref>Template:Cite journal</ref>

• It may begin with something that rubs, irritates, or scratches the skin, such as clothing.
• This causes the person to rub or scratch the affected area. Constant scratching causes the skin to thicken.
• The thickened skin itches, causing more scratching, causing more thickening.
• Affected area may spread rapidly through the rest of the body.

Many hypothesize LSC has a psychosomatic origin.<ref name=":1">Template:Cite journal</ref> Those predisposed to itch as a response to emotional tensions may be more susceptible to the itch-scratch cycle. It may also be associated with nervousness, anxiety, depression, and other psychological disorders.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> Many people with LSC are aware of the scratching they do during the day, but they might not be aware of the scratching they do in their sleep.<ref name=":0" /> LSC is also associated with atopy, or atopic dermatitis (eczema) and an increase of histamine levels.<ref name=":0" />

Diagnosis

LSC is typically diagnosed by careful observation and history taking.<ref name=":1" /> It is easily recognized (see signs and symptoms, and gallery).<ref name=":0" /> Biopsies are sometimes necessary to confirm the diagnosis and differentiate it from other similar appearing lesions.

Treatment

Treatment is aimed at reducing itching and minimizing existing lesions because rubbing and scratching exacerbate LSC. The itching and inflammation may be treated with a lotion or steroid cream (such as triamcinolone or Betamethasone) applied to the affected area of the skin.<ref>Template:Cite journal</ref> Night-time scratching can be reduced with sedatives and antihistamines.<ref name=":0" /> Doxepin is often prescribed, as it offers both antihistamine properties and is also effective at reducing the (itch scratch cycle) associated with the obsessive psychosomatic behavioral symptoms.

Gallery

• Lichen simplex chronicus 1.jpg
• Lichen simplex chronicus 2.jpg
• Lichen simplex chronicus 3.jpg
• Lichen simplex chronicus 4.jpg

See also

• List of cutaneous conditions