Lichen Simplex Chronicus - Causes, Symptoms & Treatment

Lichen simplex chronicus (LSC) also known Neurodermatitis. It is a stubborn skin condition characterized by chronic itching and scratching. Some skin types are more prone to lichenification, such as skin that tends toward eczematous conditions (ie, atopic dermatitis, atopic diathesis). Central and peripheral neural tissue and inflammatory cell products in the perception of itch and ensuing changes in LSC. The possible interplay among primary lesions, psychic factors, and the intensity of pruritus additively influence the extent and severity of LSC. Eventually, the affected skin becomes thick and leathery. LSC is found on the skin in regions accessible to scratching. Pruritus provokes rubbing that produces clinical lesions, but the underlying pathophysiology is unknown.LSC occurs mostly in mid-to-late adulthood, with highest prevalence in persons aged 30-50 years. LSC is observed more commonly in females than in males.

Lichen simplex chronicus is seen around the ankles, shins and the back or side of the neck. The forearms may also be extensively involved. Lichen simplex chronicus is often caused by constant rubbing of the skin. Lichen nuchae is a form of lichen simplex that occurs on the midposterior neck and is observed almost exclusively in women. The rubbing begins the chain of events that leads from itching to scratching and then to the presence of leather-like skin patches.Lichen simplex chronicus is often caused by constant rubbing of the skin. The rubbing begins the chain of events that leads from itching to scratching and then to the presence of leather-like skin patches. Symptoms are chronic itching which is often accompanied by nervous tension. The appearance of scratch marks and the leathery skin patches can be found anywhere on the body. Prolonged lichen simplex chronicus can result in brown-colored pigmentation at the site of irritation.

Causes of Lichen Simplex Chronicus

Common causes of Lichen Simplex Chronicus

• Constant rubbing of the skin.
• Insect bites.
• Scars (eg, traumatic, postherpetic/zoster).
• Acne keloidalis nuchae.
• Venous insufficiency.
• Asteatotic.
• Psychological factors( Anxiety and Neurodermatitis).
• Lithium.
• Eczema.

Symptoms of Lichen Simplex Chronicus

Common Symptoms of Lichen Simplex Chronicus

• Itching.
• Skin lesion.
• Lesions.
• Anxiety.
• Stress.
• Inflammation.

Treatment of Lichen Simplex Chronicus

Common Treatment of Lichen Simplex Chronicus

• Occlusion also provides a physical barrier to the scratching. Midpotency topical steroids are not recommended for thin skin (eg, vulva, scrotum, axilla, face).
• Direct long-term therapy more at daily use of low-potency nontrophogenic topical corticosteroids.
• Antihistamines such as diphenhydramine (Benadryl) and hydroxyzine (Atarax) are common.
• Doxepin (Sinequan) and clonazepam (Klonopin) may be considered in appropriate cases.
• Other topical medications reported to decrease pruritus include doxepin cream and capsaicin cream.
• Aspirin/dichloromethane is effective in patients with LSC..
• Used in directing the changes in cellular activity that induce itching and inflammation.
• Over-the-counter hydrocortisone creams or prescription steroid creams can help ease itching and inflammation. Soaps or lotions containing coal tar may be helpful, too.
• Antidepressants or anti-anxiety medications are helpful for some people. If you develop a bacterial infection in the rash, your doctor may prescribe an antibiotic lotion or oral antibiotics.
• Cover the affected area. Bandages or dressings can help protect the affected area. This may be especially important if you scratch during your sleep.
• Avoid things that increase itching.
• Sedatives or tranquilizers may be prescribed to combat the nervous tension and anxiety that often accompanies the condition.

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