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Lichen Simplex ChronicusFor simplicity reasons this condition is called LSC. It is characterized by chronic itching and scratching as a skin disorder. A thick leathery brownish skin is caused by the itching and scratching. These skin conditions then trigger itching and an infinite loop. CauseThe illness can be started by something that is least suspected, anything that rubs or irritates. An irritant such as clothing might start scratching and be a least expected source. Thickening of the skin occurs from the constant scratching. LSC is more appropriately called a symptom rather than a specific disease. The skin inflammation can be caused by a habitual scratching of a certain area after a long period of time. Characteristic changes result such as thickening and darkening of the skin with papules that result from the scratching. Skin lines then become more prominent. These changes have a name. The collective name of lichenification is what the changes are called that result from initial symptoms. Lichen simplex chronicus is similar to other skin conditions such as atopic dermatitis, eczema or psoriasis. Nervousness, anxiety, depression and other psychological disorders have also been known to cause lichen simplex chronicus. ChildrenThis illness is common in children. Children have less control over their impulses and have a tendency to scratch insect bites. A major high-risk group is mentally retarded children. Due to their mental incapacity they have a predisposition for repetitive movements of their limbs such as habitual and uncontrolled movements that lead to rubbing and irritating certain areas. People with eczema are also likely to get lichen simplex. The entire body can be affected by eczema while LSC typically only happens in one area. The affected area is when the nerves terminate causing an irritable and trigger the itch- scratch- itch cycle. The more individuals scratch and rub the eruption the more the itch and the cycle continues. AppearanceThe ankles, wrists, back, side of the neck, forearm portion of the elbow, scrotum, uvula and pubis, upper eyelids, ear opening and fold behind the ear are the most common areas for lichen simplex. TreatmentStopping the scratching is the first step in treatment of LSC. An important part of LSC treatment is counseling. A patient needs to know the importance of not scratching. Stress management and behavior modification has to be taught since it is also a stress-induced illness. The itching and inflammatory areas may also be treated with medication, lotion or steroid creams. The thickened lesions may be treated with salicylic acid. A doctor may recommend soaps or lotions that contain coal tar. Other useful treatments include anti histamines, sedatives or tranquilizers. The scratching sensation is benumb and tranquilizers also help to reduce stress. To reduce inflammation and itching, steroids may be directly introduced into the inflamed area. When LSC has a proven emotional cause then anti depressants and tranquilizers may be needed. The Importance of Counseling in the LSC ManagementIt is important to understand that all itching, rubbing and even touching of the rash needs to stop. It is a good idea to keep the afflicted area well covered since many people scratch in their sleep. LSC is typically treated like chronic eczema. The patches are exacerbated by water and soap so to keep the spot soft and moist without being wet or oozy without aggravation you should apply emollients. To control the symptoms, topical steroids are needed. If strong steroids such as hydrocortisone cream are required they should only be used under medical advice and supervision. A patient shouldn’t buy self-prescribed ointments over the counter since a physician is required for periodic monitoring and advise. Complications of Lichen Simplex ChronicusThere are some complications that can develop from lichen simplex chronicus. Bacterial and fungus infections could set in on the scratch spot which could lead to a secondary bacterial skin infection. The scratch spot can be made vulnerable and wet due to the rubbing. After curing there can be permanent scars left and a permanent change of color.
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