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Lichen Simplex Chronicus

Alternate Names

  • localized scratch dermatitis
  • Lichen simplex chronicus

Definition

Lichen simplex chronicus is a skin disorder characterized by chronic itching, inflammation and thickening of the top layer of the skin.

What is going on in the body?

Lichen simplex chronicus likely begins with a minor irritation of the skin, causing the person to rub or scratch the area. This causes thickening of the skin. The thickened skin itches, causing more scratching and more thickening. This is called the "itch-scratch-itch" cycle.

Risks

What are the causes and risks of the condition?

Lichen simplex chronicus is most often seen in adults. It may begin with a minor skin irritation, causing the person to scratch the area. Dryness of the skin makes the itching worse.
Psychological factors, such as anxiety and depression, may play a role. The condition is not allergic. Scratching the skin raw can result in secondary infection..

Prevention

What can be done to prevent the condition?

To prevent lichen simplex chronicus, one must prevent the "itch-scratch-itch" cycle from beginning by not scratching and rubbing the skin..If the skin is dry, moisturize it to reduce itch. Keep fingernails short to avoid trauma to the skin. Control of stress and other emotional conditions may be helpful in the prevention of this condition.

Diagnosed

How is the condition diagnosed?

The diagnosis of lichen simplex chronicus is based on the appearance of the skin, and a history of chronic itching and scratching.

Long Term Effects

What are the long-term effects of the condition?

The skin lesions of lichen simplex chronicus may persist for years and are prone to secondary infection and scarring.

Other Risks

What are the risks to others?

There are no risks to others, as lichen simplex chronicus is not contagious.

Treatments

What are the treatments for the condition?

Treatment of lichen simplex chronicus may include:
  • a skin emollient to moisten skin and reduce itching
  • topical corticosteroid cream or ointment to reduce itching and inflammation
  • corticosteroid injections into the affected area of skin to reduce itching and inflammation
  • antibiotics if secondary skin infection is present
  • keeping fingernails short to prevent trauma to the skin from inadvertent scratching
  • occlusive dressing, which covers the involved skin completely, to completely prevent the person from scratching
  • antihistamines to relieve the itching
  • sedatives and tranquilizers to reduce stress
  • antidepressants, if there is an emotional component to the condition
  • counseling, stress management, or behavior modification

Side Effects

What are the side effects of the treatments?

Side effects of treatment depend on the medication used. They may include drowsiness, dry mouth, and allergic reactions.

After Treatment

What happens after treatment for the condition?

Lichen simplex chronicus skin lesions generally clear up completely with treatment. However, they may recur later.

Monitor

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Hill, Marcia J. Skin Disorders: Mosby's Clinical Nursing Series, 1994

Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

The Merck Manual of Medical Information, 1997

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