Skip to main content

Last Updated on June 7, 2024

Lichen Simplex Chronicus (LSC) is a skin disorder characterized by chronic itching and scratching, leading to thickened, leathery skin. It is not a primary skin condition but rather a consequence of an ongoing itch-scratch cycle. It typically occurs in individuals aged 30 to 50 years. 

This blog will explore the causes, symptoms, diagnosis, and treatment of this condition to provide a comprehensive understanding of this condition. Furthermore, it can help individuals suffering from this condition how to take care of their condition and manage it effectively. 

Also Read: Is Eczema An Autoimmune Disease or Something Else?

What is Lichen Simplex Chronicus?

Lichen Simplex Chronicus is an itchy skin condition that can cause thick, rough patches. While the cause is unknown, stress and dry skin might play a role. Additionally, symptoms include intense itch, red scaly patches, and sometimes broken skin. It’s not contagious, but it can be bothersome. It is essential to consult a healthcare professional and manage your condition properly. 

Who is at Risk?

Lichen simplex chronicus can affect individuals of any age, race, or sex. However, it is more prevalent among women and typically seen in middle-aged and older adults. Additionally, some conditions that may trigger a scratch-itch cycle leading to lichen simplex chronicus include insect bites, scars, atopic dermatitis, dry skin, poor leg circulation, anxiety, and stress. 

Causes

Lichen simplex arises from a chronic itch-scratch cycle. Additionally, repetitive scratching and excoriation lead to the development of well-defined, thickened patches. Moreover, the initial trigger for the itching can vary; 

  • Skin allergies 
  • Atopic Dermatitis 
  • Psoriasis 
  • High Level of Stress 

 Moreover, primary lichen simplex appears on normal skin. Furthermore, secondary lichen simplex follows an underlying itchy skin condition such as atopic dermatitis, psoriasis, scabies, or xerosis. Neural-mediated stimuli that cause itching include brachioradial pruritus and radiculopathy. Moreover, environmental triggers encompass heat, sweat, chemical irritants, and insect bites. 

What are the clinical features of lichen simplex? 

Lichen simplex chronicus consists of one or more lichenified patches or plaques on the skin. Moreover, lichenification that results from the chronic itching and scratching cycle causes an exaggeration of the normal skin marking creases giving a ‘criss-cross’ pattern. Additionally, other clinical characteristics may include:  

  • Hyper- or hypopigmentation  
  • Scaly skin 
  • Thickened skin 
  • Excoriation 
  • Broken hairs (the brush sign), or alopecia in affected areas. 

Additionally, Lichen simplex can present with single or multiple lesions, often in areas that are easy to reach. They most commonly involve the:

  • Neck and scalp 
  • Vulva, pubis, and scrotum 
  • Wrists and extensor forearms 
  • Ankles, lateral shins, and thighs. 

Possible Complications

Possible complications of Lichen Simplex Chronicus (LSC) include skin infections due to persistent scratching and breaking of the skin barrier, leading to bacterial, viral, or fungal infections. Moreover, the chronic nature of the condition can result in thickened, leathery skin (lichenification) and permanent changes in skin color or texture.  

Additionally, persistent itching and discomfort can also significantly impact the patient’s quality of life, potentially leading to sleep disturbances and psychological issues such as anxiety or depression. Moreover, the repeated use of potent topical treatments, like corticosteroids, may cause side effects such as skin thinning or systemic absorption issues if not properly managed. 

Diagnosis

Diagnosing Lichen Simplex Chronicus involves a thorough clinical examination and detailed patient history. Furthermore, it can be confused with eczema, psoriasis, or mycosis fungoides, so it is essential to confirm your diagnosis. 

Additionally, the following steps are typically taken to confirm the diagnosis: 

Physical examination

A dermatologist will examine the affected skin areas, looking for characteristic signs of LSC, such as thickened, leathery patches with prominent skin lines. 

Patient history

The doctor will take a detailed history, including the duration and pattern of itching, any known triggers, underlying medical conditions, and psychological factors. 

Skin biopsy

In some cases, a skin biopsy may be performed to rule out other skin conditions and confirm the diagnosis. Additionally, a small sample of the affected skin is taken and examined under a microscope. 

Patch testing

If contact dermatitis is suspected as the underlying cause, patch testing may be conducted to identify specific allergens. 

Neurological assessment

If nerve disorders are suspected, a neurological assessment may be necessary to identify any underlying nerve issues contributing to the itching. 

Treatment\ Mangement

Effective treatment of Lichen Simplex Chronicus focuses on breaking the persistent itch-scratch cycle and addressing the underlying causes of the itching similar to atopic dermatitis. A multi-faceted approach is often necessary to manage the condition comprehensively.  

Furthermore, topical corticosteroids, such as high-potency creams or ointments, are frequently prescribed to reduce inflammation and itching, but they must be used under the guidance of a healthcare professional to avoid potential side effects. Oral antihistamines can be particularly helpful in alleviating severe itching, especially if it disrupts sleep. Additionally, regular use of moisturizers is essential to keep the skin hydrated and reduce dryness, which can significantly alleviate itching.  

Moreover, behavioral therapy, including cognitive-behavioral therapy (CBT), can play a crucial role in addressing the psychological factors contributing to LSC, while anti-anxiety medications may be prescribed if stress and anxiety are significant contributors to the condition. Non-steroidal topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, can effectively reduce inflammation and itching, particularly in sensitive areas like the face and genital region.  

At Home Care

Additionally, with your give treatment it is also better to manage Lichen Simplex Chronicus at home with these tips; 

  • Avoid known triggers: Identify and avoid substances or situations that trigger itching, such as certain fabrics, soaps, or environmental allergens. 
  • Maintain good skin hygiene: Regularly cleanse and moisturize the skin to prevent dryness and irritation. 
  • Use gentle skincare products: Choose mild, fragrance-free skincare products to minimize irritation. 
  • Wear loose-fitting clothing: Loose, breathable clothing can help reduce skin friction and irritation. 
  • Manage stress: Practice stress-reducing techniques, such as meditation, yoga, or deep breathing exercises, to help manage psychological factors contributing to itching. 
  • Keep nails short: Trim nails regularly to reduce the risk of damaging the skin during scratching. 
  • Use cool compresses: Applying cool compresses to itchy areas can provide relief and reduce the urge to scratch. 

Also Read: Alopecia Areata Self-Care and Medical Treatment

Conclusion

Lichen Simplex Chronicus is a complex condition that requires a careful approach to manage effectively. Understanding the underlying causes and triggers of itching is crucial in developing an effective treatment plan. Moreover, by breaking the itch-scratch cycle and addressing both physical and psychological factors, individuals can achieve significant improvement in their skin condition and overall quality of life.  

Additionally, if you suspect you have Lichen Simplex Chronicus, consult with a dermatologist to receive a proper diagnosis and personalized treatment plan. 

Leave a Reply