Lichen simplex chronicus is a skin disorder that leads to chronic itching and scratching.
Causes, incidence, and risk factorsThis disorder may occur with:
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.
SymptomsThis skin disorder leads to a scratch-itch cycle:
Symptoms include:
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.
TreatmentThe 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 medication creams. They are left in place for a week or more at a time.
Antihistamines, sedatives, or tranquilizers may be needed to reduce itching and stress. Steroids may be injected directly into lesions to reduce itching and inflammation.
Patients who have an emotional component to their lichen simplex chronicus may need antidepressants and tranquilizers.
Expectations (prognosis)You can control lichen simplex chronicus by reducing stress and scratching less. The condition may return or change sites.
ComplicationsCall your health care provider if:
Lichen simplex chronicus is a skin disorder that leads to chronic itching and scratching.
Causes, incidence, and risk factorsThis disorder may occur in people who have:
It is common in children, who cannot stop scratching insect bites and other itchy skin conditions. It can also be common in children who have chronic repetitive movements.
SymptomsThis skin disorder leads to a scratch-itch cycle:
Symptoms include:
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.
TreatmentThe 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 moisturize, cover, and protect the area may be used with or without medication creams. They are left in place for a week or more at a time.
Antihistamines, sedatives, or tranquilizers may be needed to reduce itching and stress. Steroids may be injected directly into lesions to reduce itching and inflammation.
Patients who have an emotional component to their lichen simplex chronicus may need antidepressants and tranquilizers.
Expectations (prognosis)You can control lichen simplex chronicus by reducing stress and scratching less. The condition may return or change sites.
ComplicationsCall your health care provider if:
Habif TP. Ezcema and hand dermatitis. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 3.
Reviewed ByReview Date: 10/10/2010
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Early, gentler substitutes for scratching can entirely prevent lichen simplex chronicus.
Resistant cases of lichen simplex chronicus will often respond to cortisone-like drugs injected directly into the lesions.
A dermatologist, a physician specializing in the study and treatment of skin disorders, can make a diagnosis after a visual exam.
Sedatives or tranquilizers may be prescribed to combat the nervous tension and anxiety that often accompanies the condition.
infection is greatly increased when the outer layer of protective skin is broken. Skin usually repairs itself quickly; however, in the case of lichen simplex chronicus, healing skin causes more itching and more scratching causes a thickening of the skin
Symptoms are chronic itching which is often accompanied by nervous tension. The appearance of scratch marks and the leathery skin patches can be found anywhere on the body. A
Treatment of the itching is necessary to stop the scratching and resulting skin damage. There are a number of ways to stop itching. Perhaps the most important is to cut fingernails very short.
Ice can substitute for the relief of scratching. Heat and fuzzy clothing worsen itching; cold and smooth clothing pacify it. If the itching is persistent, dressings may be applied to the affected areas
Diligent adherence to treatment is usually rewarded with a resolution of the condition. The original cause of itching may be gone, or it may reappear. Preventive treatment in its early stages will arrest the process.
Fluocinonide. I have itched and scratched for months, visited two dermotoligist, and in about 4 weeks of heavy treatment I'm 95% itch free. This is the strogest steroid ointment you can get. Listen to your doctors intructions for use.
Reducing the buildup of thick skin may require medicines that dissolve or melt keratin, the major chemical in skin's outer layer. These keratolytics include urea, lactic acid, and salicylic acid.
All these medicines work better under occlusion, which means putting a waterproof barrier like a rubber glove or plastic wrap over them. For broken skin, topical antibiotics like bacitracin help prevent infection.