Lichen simplex chronicus

Lichen simplex chronicus

Micrograph of lichen simplex chronicus. H&E stain.
Classification and external resources
Specialty	dermatology
ICD-10	L28.0
ICD-9-CM	698.3
DiseasesDB	31441
MedlinePlus	000872
eMedicine	derm/236
MeSH	D009450

Lichen simplex chronicus (also known as "Neurodermatitis"^[1]) is a skin disorder characterized by chronic itching and scratching.^[2]^:58 The constant scratching causes thick, leathery, brownish skin. This condition is more common between ages 30 and 50 and is seen more in women than in men.^[3]

Causes

This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:

It may begin with something that rubs, irritates, or scratches the skin, such as clothing.
This causes the person to rub or scratch the affected area. Constant scratching causes the skin to thicken.
The thickened skin itches, causing more scratching, causing more thickening.
Affected area may spread rapidly through the rest of the body.

The skin may become leathery and brownish in the affected area. This disorder may be associated with atopic dermatitis (eczema) or psoriasis. It may also be associated with nervousness, anxiety, depression, and other psychological disorders.

It is common in children, who chronically scratch insect bites and other areas.

Treatment

Treatment is aimed at reducing itching and minimizing existing lesions because rubbing and scratching cause lichen simplex chronicus. The itching and inflammation may be treated with a lotion or steroid cream (such as Betamethasone) applied to the affected area of the skin.

Suggestion

Keep fingernails very short to minimize skin damage when scratching is unavoidable.

Gallery

References

↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
↑ Tamparo, Carol. Diseases of the Human Body (Fifth ed.). Philadelphia, PA. p. 201. ISBN 978-0-8036-2505-1.

Diseases of the skin and appendages by morphology

Growths

Epidermal	wart callus seborrheic keratosis acrochordon molluscum contagiosum actinic keratosis squamous-cell carcinoma basal-cell carcinoma Merkel-cell carcinoma nevus sebaceous trichoepithelioma

Pigmented	Freckles lentigo melasma nevus melanoma

Dermal and subcutaneous	epidermal inclusion cyst hemangioma dermatofibroma (benign fibrous histiocytoma) keloid lipoma neurofibroma xanthoma Kaposi's sarcoma infantile digital fibromatosis granular cell tumor leiomyoma lymphangioma circumscriptum myxoid cyst

Rashes

With
epidermal
involvement

Eczematous	contact dermatitis atopic dermatitis seborrheic dermatitis stasis dermatitis lichen simplex chronicus Darier's disease glucagonoma syndrome langerhans cell histiocytosis lichen sclerosus pemphigus foliaceus Wiskott–Aldrich syndrome Zinc deficiency

Scaling	psoriasis tinea (corporis cruris pedis manuum faciei) pityriasis rosea secondary syphilis mycosis fungoides systemic lupus erythematosus pityriasis rubra pilaris parapsoriasis ichthyosis

Blistering	herpes simplex herpes zoster varicella bullous impetigo acute contact dermatitis pemphigus vulgaris bullous pemphigoid dermatitis herpetiformis porphyria cutanea tarda epidermolysis bullosa simplex

Papular	scabies insect bite reactions lichen planus miliaria keratosis pilaris lichen spinulosus transient acantholytic dermatosis lichen nitidus pityriasis lichenoides et varioliformis acuta

Pustular	acne vulgaris acne rosacea folliculitis impetigo candidiasis gonococcemia dermatophyte coccidioidomycosis subcorneal pustular dermatosis

Hypopigmented	tinea versicolor vitiligo pityriasis alba postinflammatory hyperpigmentation tuberous sclerosis idiopathic guttate hypomelanosis leprosy hypopigmented mycosis fungoides

Without
epidermal
involvement

Red

Blanchable
Erythema

Generalized	drug eruptions viral exanthems toxic erythema systemic lupus erythematosus

Localized	cellulitis abscess boil erythema nodosum carcinoid syndrome fixed drug eruption

Specialized	urticaria erythema (multiforme migrans gyratum repens annulare centrifugum ab igne)

Nonblanchable
Purpura

Macular	thrombocytopenic purpura actinic/solar purpura

Papular	disseminated intravascular coagulation vasculitis

Indurated

Miscellaneous
disorders

Ulcers

Hair	telogen effluvium androgenic alopecia trichotillomania alopecia areata systemic lupus erythematosus tinea capitis loose anagen syndrome lichen planopilaris folliculitis decalvans acne keloidalis nuchae

Nail	onychomycosis psoriasis paronychia ingrown nail

Mucous membrane	Aphthous stomatitis oral candidiasis lichen planus leukoplakia pemphigus vulgaris mucous membrane pemphigoid cicatricial pemphigoid herpesvirus coxsackievirus syphilis systemic histoplasmosis squamous-cell carcinoma

Dermatitis and eczema (L20–L30, 690–693,698)

Atopic dermatitis	Besnier's prurigo

Seborrheic dermatitis	Pityriasis simplex capillitii Cradle cap

Contact dermatitis (allergic, irritant)	plants: Urushiol-induced contact dermatitis African blackwood dermatitis Tulip fingers other: Abietic acid dermatitis Diaper rash Airbag dermatitis Baboon syndrome Contact stomatitis Protein contact dermatitis

Eczema	Autoimmune estrogen dermatitis Autoimmune progesterone dermatitis Breast eczema Ear eczema Eyelid dermatitis Topical steroid addiction Hand eczema Chronic vesiculobullous hand eczema Hyperkeratotic hand dermatitis Autosensitization dermatitis/Id reaction Candidid Dermatophytid Molluscum dermatitis Circumostomy eczema Dyshidrosis Juvenile plantar dermatosis Nummular eczema Nutritional deficiency eczema Sulzberger–Garbe syndrome Xerotic eczema

Pruritus/Itch/ Prurigo	Lichen simplex chronicus/Prurigo nodularis by location: Pruritus ani Pruritus scroti Pruritus vulvae Scalp pruritus Drug-induced pruritus Hydroxyethyl starch-induced pruritus Senile pruritus Aquagenic pruritus Aquadynia Adult blaschkitis due to liver disease Biliary pruritus Cholestatic pruritus Prion pruritus Prurigo pigmentosa Prurigo simplex Puncta pruritica Uremic pruritus

Other	substances taken internally: Bromoderma Fixed drug reaction Nummular dermatitis Pityriasis alba Papuloerythroderma of Ofuji

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