What Is Lichen Simplex Chronicus?

Lichen simplex chronicus, also known as neurodermatitis, is a chronic skin problem caused by scratching or itching. This condition represents about 1 percent of all dermatology visits.

How Does It Occur?

The first symptom seen in lichen simplex chronicus is itching (medical term is pruritus). Pruritus can be caused by dry skin, contact with certain chemicals and solvents, infectious causes such as scabies, lice or fungal infections, psychological reasons and by elevated levels of certain products in the blood stream. In lichen simplex chronicus, itching/pruritus is usually the result of some underlying emotional or psychiatric problems. Frustration, stress or depression can also precipitate the itchiness.

The scratching on the skin causes redness, which eventually leads to thick lichenified plaques with prominent skin lines. This process, which is called lichenification, causes more itching and an "itch-scratch-itch" cycle perpetuates the process.

What Are The Symptoms?

Some patients will have a history of emotional or psychiatric problems. The patient will complain of itchiness in various parts of the body, which may even interfere with his sleep. Over time, continuous scratching will lead to thickened and red areas. Dry, leathery, hypertrophic, lichenified plaques occur on neck, wrists, thighs and many other areas on the body.

How Is It Diagnosed?

After ruling out other possible causes, a doctor can easily diagnose this condition from the signs, symptoms and history, which includes chronic itching, associated with pigmented lichenified skin lesions. If the doctor is concerned about some other skin condition, he may do a biopsy to exclude other possibilities. The areas of skin thickening are usually seen within reach of scratching fingers.

How Is It Treated?

Lichen simplex chronicus is difficult to treat because most patients lack insight into their condition. The best treatment advised is by asking the person not to scratch.

Topical or injected steroids may be helpful for reducing skin thickening. Some doctors use a plastic tape with steroid incorporated into the adhesive. This tape works by providing topical steroid and prevents the person from scratching the area.

Some doctors may also prescribe antihistamines such as Benadryl or Atarax to help decrease the itchiness.

What Can Be Done To Prevent Lichen Simplex Chronicus?

Since many cases of lichen simplex chronicus are due to underlying emotional or psychiatric problems, it's best for patients to have these issues addressed. Possible areas of support may include therapists, psychiatrists, counseling groups or self-help literature.

Patients should also avoid the urge to scratch and should seek medical attention when they suspect worsening or reappearance of the condition.

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