From the Research
Lichen simplex chronicus most commonly appears on areas of the body that are easily accessible for scratching, particularly the neck, ankles, wrists, forearms, lower legs, external genitalia, and the back of the neck (nape). The condition can also affect the scalp, ears, and the anal region. These locations are vulnerable because they can be readily reached for scratching and rubbing, which perpetuates the itch-scratch cycle characteristic of this condition. Lichen simplex chronicus develops when chronic scratching and rubbing of the skin leads to thickening (lichenification) and intensified itching. The condition is more common in adults, particularly those with predisposing factors like atopic dermatitis, anxiety, or stress.
Common Sites for Lichen Simplex Chronicus
- Neck
- Ankles
- Wrists
- Forearms
- Lower legs
- External genitalia (especially the vulva in women and scrotum in men)
- Back of the neck (nape)
- Scalp
- Ears
- Anal region
According to the most recent study 1, lichen simplex chronicus is a form of chronic localized pruritus with a secondary dermatitis, and one of the most common types of chronic itch conditions. The study highlights the importance of understanding the pathogenesis and aetiology of lichen simplex chronicus, which has increased greatly in recent years, enabling a substantial increase in treatment options.
Treatment and Management
Treatment typically involves breaking the itch-scratch cycle through topical corticosteroids, antihistamines for itch relief, and sometimes occlusive dressings to prevent scratching. Addressing underlying psychological factors is also important for long-term management. Other treatment options, such as topical immunomodulators, topical antipruritic agents, oral antihistamines, antiepileptics, and antidepressants, may also be considered, as suggested by the study 2.
In terms of specific treatments, the study 3 found that pimecrolimus cream 1% was effective in reducing patient symptom scores for vulvar lichen simplex chronicus. Another study 4 found that topical triamcinolone ointment was effective in reducing patient symptom scores for lichen sclerosus, which is a related condition. However, it is essential to note that these studies may not be directly applicable to lichen simplex chronicus, and more research is needed to determine the most effective treatments for this condition.
Overall, the management of lichen simplex chronicus requires a comprehensive approach that addresses the physical and psychological aspects of the condition. By understanding the common sites affected by lichen simplex chronicus and the various treatment options available, healthcare providers can provide effective care and improve patient outcomes.