Lichenification
{{More categories|date=February 2025}}{{Infobox medical condition
| name = Lichenification
| symptoms = Itching, hyperpigmentation, bumpy/ leathery skin, papules on skin
| causes = Scratching/rubbing skin, chemical irritants, friction from clothing
| treatment = Topical steroids, steroid injections, anti-itch creams
}}
Lichenification is a cutaneous condition caused by consistent irritation of the skin, such as scratching or rubbing, but can also be caused by friction from clothing or chemical irritants.{{Cite journal |last=Morris |first=Malcolm |date=1912 |title=A Discussion on Prurigo, Pruriginous Eczema, and Lichenification |journal=Proceedings of the Royal Society of Medicine |volume=5 |issue=Dermatol Sect |pages=199–200 |doi=10.1177/0035915712005003128 |issn=0035-9157 |pmc=2005919 |pmid=19975772}} Lichenification can develop from scratching existing skin conditions that cause itching such as eczema or psoriasis (secondary lichenification), but also appears on previously healthy skin when repeatedly aggravated (primary lichenification).{{Cite journal |last1=Goldblum |first1=Raymond W. |last2=Piper |first2=William N. |date=1954 |title=Artificial lichenification produced by a scratching machine |url=https://core.ac.uk/download/pdf/82266505.pdf |journal=Journal of Investigative Dermatology |volume=22 |issue=5 |pages=405–415|doi=10.1038/jid.1954.57 |pmid=13163504 }} Often times, in the case of primary lichenification, skin irritation is self inflicted due to psychiatric conditions, usually obsessive-compulsive disorder or anxiety disorder.
Appearance
The initial stage of lichenification presents as hyperpigmentation of the skin, which is followed by the appearance of small hard papules, which can often be perceived only by touch, giving the lesion a bumpy or “pebbly” texture.{{Citation |last1=Aboobacker |first1=Shamma |title=Lichenification |date=2025 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK537332/ |access-date=2025-02-06 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30726017 |last2=Harris |first2=Blair W. |last3=Limaiem |first3=Faten}} When these papules are damaged, they will excrete blood and pus and as the condition progresses, deeper layers of the skin become thickened and indurated. Once fully developed, the effected skin will present with a leathery, "bark-like" texture and remain itchy and inflamed.
Common areas of occurrence are noted in points of the body that are easily accessible or prone to itchiness, notably the nape of the neck, wrists, hands, forearms, waist, scrotum, vulva, thighs, lower legs and feet.{{Cite journal |last1=Charifa |first1=Ahmad |last2=Badri |first2=Talel |last3=Harris |first3=Blair W. |date=2023 |title=Lichen Simplex Chronicu |url=https://europepmc.org/article/MED/29763167/NBK430685#free-full-text |journal=StatPearls Publishing, Treasure Island |pmid=29763167}}
The term lichenification was coined by Louis-Anne-Jean Brocq in 1891, due to the condition’s visual similarity to lichen.
Treatment
There are several treatments for lichenification. If affected skin is left alone, the ailment can slowly go away on its own. However, due to the itch-scratch-cycle, this method is not very common.{{Cite journal |last=Rinaldi |first=Giulia |date=2019-04-30 |title=The Itch-Scratch Cycle: A Review of the Mechanisms |journal=Dermatology Practical & Conceptual |volume=9 |issue=2 |pages=90–97 |doi=10.5826/dpc.0902a03 |issn=2160-9381 |pmc=6502296 |pmid=31106010}} Generally, lichenification is treated with topical steroids and moisturizers,{{Cite journal |last1=Granlund |first1=Hakan |last2=Remitz |first2=Anita |last3=Kyllonen |first3=Hannele |last4=Lauerma |first4=Antti I. |last5=Reitamo |first5=Sakari |year=2001 |title=Treatment of lichenified atopic eczema with tacrolimus ointment |url=https://d1wqtxts1xzle7.cloudfront.net/110050731/00015550152573083-libre.pdf?1704420057=&response-content-disposition=inline%3B+filename%3DTreatment_of_Lichenified_Atopic_Eczema_w.pdf&Expires=1738823462&Signature=DqSFqeIb~86m9VeuGOulZJEGzzucbwwtXx26zxGLyDNR6sT4wYWgpEv-~VF9ZtD0sn3Oq-wChI4BY1TrCeN1BtzuUq8rwrd3DSZ6H2G8PX6x5JMVL0t3Sd90xfrX4XF23cpYurEzPKioxmfDOqowJl0CDizNoOqd3QUxROTFiRXVs06VARjiW3dQJZPW7aqu4gm0wxIABUOIwM8lezIgn4RQLWM-PZLIFW48wQNnvLdQJcuDWYEEFV5vkhmHXtnobVtEzcGvjJD~10V29wPjk8655YK31Fyqh6WyBb1nWEkWZAsFOnlfs8KtASnhrBGFhM56EfGQ2~b4DT~qW9k2QQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA |journal=Acta Dermato Venereologica |volume=81 |issue=4 |pages=314–315|doi=10.1080/00015550152573083 |pmid=11720192 }} but remedies including light-therapy and acupuncture are noted as well.
References
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