Lichen simplex chronicus
Key points
- Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching.
- This disorder may be associated with atopic dermatitis (eczema) or psoriasis.
- Signs and tests The diagnosis is primarily based on the appearance of the skin and a history of chronic itching and scratching.
- The primary treatment is to stop scratching the skin.
Definition
Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching. The constant scratching causes thick, leathery, brownish skin.
Causes, incidence, and risk factors
This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:
- 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.
- The skin may become leathery and brownish in the affected area.
This disorder may be associated with atopic dermatitis (eczema) or psoriasis. It may also be associated with nervousness, anxiety, depression, and other psychologic disorders.
It is common in children, who chronically scratch insect bites and other areas. It can also be common in mentally retarded children who have chronic repetitive movements.
Symptoms
- Itching of the skin
o May be chronic
o May be intense
o Increases with nervous tension, stress - Skin lesion, patch, or plaque
o Exaggerated skin lines over the lesion
o Circumscribed lesion with distinct borders
o Skin lesion becomes leathery textured (lichenification)
o Darkened (hyperpigmented) or reddened skin
o Excoriation, raw areas
o Scratch marks
o Scaling
o Commonly located on the ankle, wrist, neck, rectum/anal area, forearms, thighs, lower leg, back of the knee, inner elbow
Signs and tests
The diagnosis is primarily based on the appearance of the skin and a history of chronic itching and scratching. A skin lesion biopsy may be needed to confirm the diagnosis.
Treatment
The primary treatment is to stop scratching the skin. This may include counseling to become aware of the importance of not scratching, stress management, or behavior modification.
The itching and inflammation may be treated with a lotion or steroid cream applied to the affected area of the skin. Peeling ointments, such as those containing salicylic acid, may be used on thickened lesions. Soaps or lotions containing coal tar may be recommended.
Dressings that cover and protect the area may be used with or without topical medications. They are left in place for a week or more at a time.
Frequently asked questions
What is lichen simplex chronicus?
Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching. The constant scratching causes thick, leathery, brownish skin.
What are the risk factors for lichen simplex chronicus?
This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:
- 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.
- The skin may become leathery and brownish in the affected area. This disorder may be associated with atopic dermatitis (eczema) or psoriasis. It may also be associated with nervousness, anxiety, depression, and other psychologic disorders. It is common in children, who chronically scratch insect bites and other areas.
What are the symptoms of lichen simplex chronicus?
- Itching of the skin o May be chronic o May be intense o Increases with nervous tension, stress
- Skin lesion, patch, or plaque o Exaggerated skin lines over the lesion o Circumscribed lesion with distinct borders o Skin lesion becomes leathery textured (lichenification) o Darkened (hyperpigmented) or reddened skin o Excoriation, raw areas o Scratch marks o Scaling o Commonly located on the ankle, wrist, neck, rectum/anal area, forearms, thighs, lower leg, back of the knee, inner elbow Signs and tests The diagnosis is primarily based on the appearance of the skin and a history of chronic itching and scratching. A skin lesion biopsy may be needed to confirm the diagnosis.
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.