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Lichen simplex chronicus
LSC; Neurodermatitis circumscripta; Eczema - lichen simplex chronicus; Atopic dermatitis - lichen simplex chronicus; Psoriasis - lichen simplex chronicus
Lichen simplex chronicus (LSC) is a skin condition caused by chronic itching and scratching.
Chronic
Chronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...
Causes
LSC may occur in people who have:
- Skin allergies
-
Eczema
(atopic dermatitis)
Eczema
Atopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes. It is a type of eczema. Other forms of eczema include...
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Psoriasis
Psoriasis
Psoriasis is a skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patc...
ImageRead Article Now Book Mark Article - Nervousness, anxiety, depression, and other emotional problems
The problem is common in children, who cannot stop scratching insect bites and other itchy skin conditions. It also occurs in children who have chronic repetitive movements.
Symptoms
LSC leads to scratching, which then causes more itching. It often follows this pattern:
- It may start when something rubs, irritates, or scratches the skin, such as clothing.
- The person begins to rub or scratch the itchy area. Constant scratching causes the skin to thicken.
- The thickened skin itches, and this leads to more scratching. This then causes more thickening of the skin.
- The skin may become leathery and brownish in the affected area.
Symptoms include:
-
Itching
of the skin that may be long-term (chronic), intense, and that increases with stress
Itching
Itching is a tingling or irritation of the skin that makes you want to scratch the area. Itching may occur all over the body or only in one location...
ImageRead Article Now Book Mark Article - Leathery texture to skin
- Raw areas of skin
-
Scaling
Scaling
Scales are a visible peeling or flaking of outer skin layers. These layers are called the stratum corneum.
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Skin lesion
, patch, or plaque with sharp borders and a leathery texture, located on the ankle, wrist, neck, rectum, anal area, forearms, thighs, lower leg, back of the knee, and inner elbow
Skin lesion
Rashes involve changes in the color, feeling or texture of your skin.
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Exams and Tests
Your health care provider will look at your skin and ask if you have had chronic itching and scratching in the past. A skin lesion biopsy may be done to confirm the diagnosis.
Skin lesion biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
Treatment
The main treatment is to reduce the itch.
You may need to use these medicines on your skin:
- Lotion or steroid cream on the area to calm itching and irritation
- Numbing medicine
- Peeling ointments containing salicylic acid on patches of thick skin
- Soaps or lotions containing coal tar
You many need to use dressings that moisturize, cover, and protect the area. These may be used with or without medicated creams. They are left in place for a week or more at a time.
To control itching and stress you may need to take medicines by mouth, such as:
- Antihistamines
- Other oral medicines that control itch or pain
Steroids may be injected directly into the skin patches to reduce itching and irritation.
You may need to take antidepressants and tranquilizers if the cause of your itching is emotional. Other measures include:
- Counseling to help you realize the importance of not scratching
- Stress management
- Behavior modification
Outlook (Prognosis)
You can control LSC by reducing itch and controlling scratching. The condition may return or move to different areas on the skin.
Possible Complications
These complications of LSC can occur:
- Bacterial skin infection
- Permanent changes in skin color
- Permanent scar
When to Contact a Medical Professional
Call your provider if:
- Symptoms get worse
- You develop new symptoms, especially signs of skin infection such as pain, redness, drainage from the area, or fever
References
Habif TP. Eczema and hand dermatitis. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 3.
Sommer LL, Millett CR, Baker DJ. Lichen simplex chronicus. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 131.
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Lichen simplex chronicus on the ankle - illustration
Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results in a rough, scratched (excoriated), thickened skin surface which may develop increased pigmentation (hyperpigmentation) as seen here on the front part of the foot, just below the leg.
Lichen simplex chronicus on the ankle
illustration
-
Lichen simplex chronicus - illustration
Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results in a rough, scratched (excoriated), thickened skin surface that may develop increased pigmentation (hyperpigmentation).
Lichen simplex chronicus
illustration
-
Lichen simplex chronicus on the back - illustration
Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results in a rough, scratched (excoriated), thickened skin surface that may develop increased pigmentation (hyperpigmentation).
Lichen simplex chronicus on the back
illustration
-
Lichen simplex chronicus on the ankle - illustration
Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results in a rough, scratched (excoriated), thickened skin surface which may develop increased pigmentation (hyperpigmentation) as seen here on the front part of the foot, just below the leg.
Lichen simplex chronicus on the ankle
illustration
-
Lichen simplex chronicus - illustration
Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results in a rough, scratched (excoriated), thickened skin surface that may develop increased pigmentation (hyperpigmentation).
Lichen simplex chronicus
illustration
-
Lichen simplex chronicus on the back - illustration
Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results in a rough, scratched (excoriated), thickened skin surface that may develop increased pigmentation (hyperpigmentation).
Lichen simplex chronicus on the back
illustration
Review Date: 10/24/2016
Reviewed By: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
