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    Lichen simplex chronicus

    Lichen simplex chronicus is a skin condition caused by chronic itching and scratching.

    Causes

    This disorder may occur in people who have:

    • Skin allergies
    • Eczema (atopic dermatitis)
    • Psoriasis
    • Nervousness, anxiety, depression, and other emotional problems

    The problemis common in children, who cannot stop scratching insect bites and other itchy skin conditions. It is also found inchildren who have chronic repetitive movements.

    Symptoms

    This skin disorder leads to scratching which in turn causes more itching.

    • It may start whensomething that 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, causing more scratching, which causes more thickening.
    • The skin may become leathery and brownish in the problem area.

    Symptoms include:

    • Itching of the skin
      • May be long-term (chronic)
      • May be intense
      • Increases with nervous tension, stress
    • Skin lesion, patch, or plaque
      • Commonly located on the ankle, wrist, neck, rectum/anal area, forearms, thighs, lower leg, back of the knee, inner elbow
      • Deep skin lines over the problem area
      • Sharpborders to the itchy area
      • Leathery texture (lichenification)
      • Darker (hyperpigmented) or red skin
      • Raw areas
      • Scratch marks
      • Scaling

    Exams and Tests

    Your health care provider will look at your skin and ask if you have hadchronic itching and scratching in the past. A skin lesion biopsy may be done to confirm the diagnosis.

    Treatment

    Themain treatment is to stop scratching the skin. You may have:

    • Counseling to help you realize of the importance of not scratching
    • Stress management
    • Behavior modification.

    You may need to use the following medicines on your skin:

    • Lotion or steroid cream on the area to calm itching and irritation
    • 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. Thesemay be used with or without medicated creams. They are left in place for a week or more at a time.

    You may need take medicines by mouth to control itching and stress such as:

    • Antihistamines
    • Sedatives
    • Tranquilizers¬†

    Steroids may be injected directly into the skin patches areas to reduce itching and irritation.

    You may need to take antidepressants and tranquilizers to treatemotional causes for the problem.

    Outlook (Prognosis)

    You can control lichen simplex chronicus bytaking steps to control scratching and reduce stress. The condition may return or move to different areas on the skin.

    Possible Complications

    • Bacterial skin infection
    • Permanent changes in skin color
    • Permanent scar

    When to Contact a Medical Professional

    Call your health care provider if:

    • Symptoms get worse
    • You develop new symptoms, especially signs of skin infection such as pain, redness or drainage from the area, or fever

    References

    Habif TP. Ezcema and hand dermatitis. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 3.

    Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 6.

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      A Closer Look

        Self Care

          Tests for Lichen simplex chronicus

            Review Date: 11/20/2012

            Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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