Lichen Simplex Chronicus

Lichen Simplex Chronicus is a common chronic plaque of dermatitis which occurs in response to repeated rubbing or scratching without any underlying skin disorder. It occurs more frequent in women but men are also affected. It is more common on adults and occurrence before adolescence is rare.

Lichen Simplex Chronicus commonly involves nape of neck, lower legs, ankles, wrist, extensor forearm, scalp and external ear canel. Scar formation is rare, although sometimes there may be postinflammatory hyperpigmentation or hypopigmentation when accompained by secondary infection. If untreated, later becomes a nervous habit similar to nail biting.

Treatment options for Lichen Simplex Chronicus:

Stop rubbing and scratching. Disease won’t resolve if you continue to scratch. Try to avoid scratching at night, as there is possibility of scratching during sleep. For temporary relief, you can do the following:
Dabbing it with moist cloth.
Apply ice cube.
Patting the skin.
Applying the prescribe medications.
Oral antihistamines especially with a sedative effects are better during night as you will have a sound sleep and no scratching

Topical steroids Preparation:
0.05% Betamethasone, 0.05% Clobetasol, 0.025-0.1% Triamcinolone with or without occlusion gives good initial result. But you should not use it in anogenital areas, body creases and face for more than 2 weeks, as there might be a possible risk of atrophy. Strong steroids should not exceed more than 2 weeks application. It is better using with occlusion as you won’t be able to scratch when covered, thus providing better recovery. Intralesional Triamcinolone preparation (1-2.5mg/ml) can also be injected around 0.1 ml intradermally at site about 1 cm apart. It can only be injected monthly or no more than 2 times a month.

Sometimes if secondary infection occurs oral antibiotics with topical steroids is given. After a lesion starts resolving a maintainance therapy with 1% hydrocortisone is applied for several weeks. Tar preparations are very good and do not cause any atrophy.

If you have any questions about Lichen Simplex Chronicus you can ask here : Skin Care Advice