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Lichen simplex chronicus


Source: http://en.wikipedia.org/wiki/Lichen_simplex_chronicus
Updated: 2017-09-01T05:49Z
Lichen simplex chronicus
Lichen simplex chronicus - very low mag.jpg
Micrograph of lichen simplex chronicus. H&E stain.
Classification and external resources
Specialty{{#statements:P1995}}
ICD-10L28.0
ICD-9-CM698.3
DiseasesDB31441
MedlinePlus000872
eMedicinederm/236
Patient UKLichen simplex chronicus
MeSHD009450
[[[d:Lua error in Module:Wikidata at line 1016: attempt to index field 'wikibase' (a nil value).|edit on Wikidata]]]

Lichen simplex chronicus (LSC) (also known as "Neurodermatitis"[1]) is a skin disorder characterized by chronic itching and scratching.[2] The constant scratching causes thick, leathery, darkened, (lichenified) skin. This condition is associated with many factors, including the scratch-itch cycle, psychological stressors, and atopy. LSC is more common between ages 35 and 50 and is seen approximately twice as often in women compared to men.[3]

Signs and symptoms

People burdened with LSC report pruritus, followed by uncontrollable scratching of the same body region, excessively.[2] Most common sites of LSC are the sides of the neck, the scalp, ankles, vulva, pubis, scrotum, and extensor sides of the forearms.[3] However, due to the stigma associated with chronic scratching, some patients will not admit to chronic rubbing or abrasion. The skin may become thickened and hyperpigmented (lichenified) as a direct result of chronic exoriation.[3] Typically this period of increased scratching is associated with stressors.

Causes

This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:[4]Whskkpoppokø vfxjcdlkeaæjdklæjdwqwdhidjdijgjjgjirghreæagrhoæergherighirhihrrtrttj DsSd

  • 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.

Many hypothesize LSC has a psychosomatic origin.[3] Those predisposed to itch as a response to emotional tensions may be more susceptible to the itch-scratch cycle. It may also be associated with nervousness, anxiety, depression, and other psychological disorders.[5][6] Many people with LSC are aware of the scratching they do during the day, but they might not be aware of the scratching they do in their sleep.[2] LSC is also associated with atopy, or atopic dermatitis (eczema).[2]

Diagnosis

LSC is typically diagnosed by careful observation and history taking.[3] It is easily recognized (see signs and symptoms, and gallery).[2] Biopsies are not necessary, and cannot be used to distinguish LSC from psoriasis.

Treatment

Treatment is aimed at reducing itching and minimizing existing lesions because rubbing and scratching exacerbate LSC. The itching and inflammation may be treated with a lotions or steroid cream (such as triamcinolone or Betamethasone) applied to the affected area of the skin.[7] Nighttime scratching can be reduced with sedatives and antihistamines.[2] SSRIs can effectively reduce the scratching associated with obsessive psychosomatic behaviors.

Gallery

See also

References

  1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0. 
  2. ^ a b c d e f Lynch, Peter J. (2004-01-01). "Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region". Dermatologic Therapy. 17 (1): 8–19. ISSN 1396-0296. PMID 14756886. 
  3. ^ a b c d e Lotti, Torello; Buggiani, Gionata; Prignano, Francesca (2008-01-01). "Prurigo nodularis and lichen simplex chronicus". Dermatologic Therapy. 21 (1): 42–46. ISSN 1529-8019. doi:10.1111/j.1529-8019.2008.00168.x. 
  4. ^ Lee, Michael R.; Shumack, Stephen (2005-11-01). "Prurigo nodularis: a review". The Australasian Journal of Dermatology. 46 (4): 211–218; quiz 219–220. ISSN 0004-8380. PMID 16197418. doi:10.1111/j.1440-0960.2005.00187.x. 
  5. ^ Konuk, Numan; Koca, Rafet; Atik, Levent; Muhtar, Sennur; Atasoy, Nuray; Bostanci, Bora (2007-05-01). "Psychopathology, depression and dissociative experiences in patients with lichen simplex chronicus". General Hospital Psychiatry. 29 (3): 232–235. ISSN 0163-8343. doi:10.1016/j.genhosppsych.2007.01.006. 
  6. ^ Krishnan, Anjeli; Koo, John (2005-07-01). "Psyche, opioids, and itch: therapeutic consequences". Dermatologic Therapy. 18 (4): 314–322. ISSN 1396-0296. PMID 16297003. doi:10.1111/j.1529-8019.2005.00038.x. 
  7. ^ Yosipovitch, Gil; Bernhard, Jeffrey D. (2013-04-25). "Chronic Pruritus". New England Journal of Medicine. 368 (17): 1625–1634. ISSN 0028-4793. PMID 23614588. doi:10.1056/NEJMcp1208814. 
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