Lichen simplex chronicus

Lichen simplex chronicus is generally a symptom defined as skin eruption brought about by continuous scratching of the skin for prolonged periods.

Scratching the site can lead to distinct alterations such as solidifying and blackening as well as highlighting of the normal skin line. The changes in the skin is called as “lichenification” since it strikingly resembles lichen that grows on rocks and trees in the forest.

This condition is typically seen among individuals with eczema. Even though eczema can affect the entire body, the eruption of lichen simplex chronicus occurs in one area. The nerve endings in the site are irritated and instigate an itch-scratch-itch cycle. If the area is scratched or rubbed, the itchiness intensifies, and the cycle continues.

What are the risk factors?

The condition is prevalent among adults. It is likely to develop among women than men and often between the ages of 30-50.

Certain conditions that can lead to the skin condition include the following:

  • Psoriasis
  • Atopic eczema
  • Insect bites
  • Contact eczema
  • Fungal skin infections
  • Shingles

What are the indications?

Lichen simplex chronicus has the same appearance as the lichen on rocks. It generally arises as a single patch or plaque with an oval or round pattern.

In most cases, the surface appears dry and scaly while the bordering skin feels thick and leathery. The rash is often reddened with discoloration that is pigmented and irregular. In addition, there are associated scratch marks close to the rash.

The usual sites that are affected by lichen simplex chronicus include:

  • Wrist and ankle
  • Outer, lower region of the leg
  • Upper eyelids
  • Fold behind the ear
  • Back and side of the neck
  • Opening of the ear
  • Forearm region of the elbow

Management of lichen simplex chronicus

The effectivity of treatment for lichen simplex chronicus is achieved with a combination of measures to allow healing of the rash and deal with the underlying condition.

The commonly used treatment options include:

  • Avoid scratching – always bear in mind that rubbing or scratching the site must be stopped. The site must be covered since many individuals scratch it while sleeping. Another option is to wear cotton gloves at night and ensure that the nails are filed down to lessen the damage in case scratching occurs. If the itchiness is severe, medications might be needed to keep it under control.
  • Limiting exposure to water and soap and regular application of emollients
  • Topical steroid creams – steroids are needed to control the symptoms. Since steroids are strong, the doctor might prescribe the appropriate one. Hydrocortisone cream is an over-the-counter option. In some cases, a steroid shot is given directly into the plaque.
  • Coal tar – these products can help in the treatment of the skin condition
  • Appropriate clothes – reducing the itchiness can be achieved by wearing certain clothing over others.


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