Lichen Simplex Chronicus – What is that?!

Lichen Simplex Chronicus is a chronic disorder that is a result of repeatedly scratching the same patch of skin.  The condition is self-induced and is a patient’s response to satisfying the need to scratch an area that continues to be itchy.  

This skin then changes from the constant scratching or rubbing and will thicken and appear leathery as compared to the unaffected surrounding skin.  The patches or plaques are usually red in color and are well demarcated.  In some patients the areas may also become darker and develop hyperpigmentation.  There may be one or multiple lesions and women are twice as likely to develop this as men.  Areas that are commonly affected include neck and scalp, the genital areas, wrists and extensor forearms, ankles, lateral shins and the thighs.

This condition may start from a mild dermatitis that would normally be transient and temporary but due to repeated scratching an itch-scratch cycle is created and the constant friction across the affected skin causes both relief and recurrent itch sensation.

This problem is sometimes seen in people who are affected by anxiety or psychiatric related illnesses. Diagnosis is often made by clinical presentation but in some cases a biopsy may be needed to confirm and rule out other skin conditions.

Treatment consists of use of corticosteroids – either applied topically or injected directly into the lesions.  Antihistamines can also be used and ones with a sedating effect are helpful for those who find the itch disrupts their sleep.  What is as important or even more important is educating the patient as to their part in causing or continuing this condition.  Making the patient aware that any rubbing, scratching or physical manipulation on their part – whether they are aware or unaware of doing it – needs to be stopped in order to resolve this.  Physical barriers and/or bandaging the areas can be used in the case of subconscious scratching.   Reducing stress, avoiding triggers, keeping nails short and treatment of underlying psychiatric disorders as well as use of emollients are also needed and helpful measures. 

Here at Dermatology and Skin Cancer Institute we are happy to help you with Lichen Simplex Chronicus as well as any other skin concerns you may have. 

Call Amy Hahn, PA-C for an appointment in our Lansdale, PA office, or to see another provider in our Fort Washington, PA office, just call 215-361-3376 press option 1.