lichen simplex chronicus

People burdened with LSC report pruritus, followed by uncontrollable scratching of the same body region, excessively.{{Cite journal|last=Lynch|first=Peter J.|date=2004-01-01|title=Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region|journal=Dermatologic Therapy|volume=17|issue=1|pages=8–19|issn=1396-0296|pmid=14756886|doi=10.1111/j.1396-0296.2004.04002.x|s2cid=22038447|doi-access=free}} Most common sites of LSC are the sides of the neck, the scalp, ankles, vulva, pubis, scrotum, and extensor sides of the forearms. 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. Typically this period of increased scratching is associated with stressors.

This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:{{Cite journal|last1=Lee|first1=Michael R.|last2=Shumack|first2=Stephen|date=2005-11-01|title=Prurigo nodularis: a review|journal=The Australasian Journal of Dermatology|volume=46|issue=4|pages=211–218; quiz 219–220|doi=10.1111/j.1440-0960.2005.00187.x|issn=0004-8380|pmid=16197418|s2cid=30087432}}

• 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.{{Cite journal|last1=Lotti|first1=Torello|last2=Buggiani|first2=Gionata|last3=Prignano|first3=Francesca|date=2008-01-01|title=Prurigo nodularis and lichen simplex chronicus|journal=Dermatologic Therapy|language=en|volume=21|issue=1|pages=42–46|doi=10.1111/j.1529-8019.2008.00168.x|pmid=18318884|s2cid=41222102|issn=1529-8019}} 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.{{Cite journal|last1=Konuk|first1=Numan|last2=Koca|first2=Rafet|last3=Atik|first3=Levent|last4=Muhtar|first4=Sennur|last5=Atasoy|first5=Nuray|last6=Bostanci|first6=Bora|date=2007-05-01|title=Psychopathology, depression and dissociative experiences in patients with lichen simplex chronicus|url=http://www.ghpjournal.com/article/S0163-8343(07)00007-2/abstract|journal=General Hospital Psychiatry|language=en|volume=29|issue=3|pages=232–235|doi=10.1016/j.genhosppsych.2007.01.006|pmid=17484940|issn=0163-8343}}{{Cite journal|last1=Krishnan|first1=Anjeli|last2=Koo|first2=John|date=2005-07-01|title=Psyche, opioids, and itch: therapeutic consequences|journal=Dermatologic Therapy|volume=18|issue=4|pages=314–322|doi=10.1111/j.1529-8019.2005.00038.x|issn=1396-0296|pmid=16297003|s2cid=25983822|doi-access=free}} 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. LSC is also associated with atopy, or atopic dermatitis (eczema) and an increase of histamine levels.

LSC is typically diagnosed by careful observation and history taking. It is easily recognized (see signs and symptoms, and gallery). Biopsies are sometimes necessary to confirm the diagnosis and differentiate it from other similar appearing lesions.

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.{{Cite journal|last1=Yosipovitch|first1=Gil|last2=Bernhard|first2=Jeffrey D.|date=2013-04-25|title=Chronic Pruritus|journal=New England Journal of Medicine|volume=368|issue=17|pages=1625–1634|doi=10.1056/NEJMcp1208814|issn=0028-4793|pmid=23614588|s2cid=1912215 }} Night-time scratching can be reduced with sedatives and antihistamines. 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.

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• List of cutaneous conditions

{{reflist}}

{{Medical resources

| DiseasesDB = 31441

| ICD10 = {{ICD10|L|28|0|l|20}}

| ICD9 = {{ICD9|698.3}}

| ICDO =

| OMIM =

| MedlinePlus = 000872

| eMedicineSubj = derm

| eMedicineTopic = 236

| MeshID = D009450

}}

{{Diseases of the skin and appendages by morphology}}

{{Diseases of the skin and subcutaneous tissue}}

Category:Pruritic skin conditions