From the Research
Lichen simplex chronicus (LSC) more commonly affects the flexor regions of the body rather than the extensor regions. This chronic skin condition, characterized by thickened, leathery skin due to persistent scratching, typically develops in areas that are easily accessible for scratching and rubbing. The most frequently affected sites include the flexor aspects of the wrists, forearms, and ankles, as well as the nape of the neck, scalp, vulva, scrotum, and perianal region. The predilection for flexor surfaces likely relates to both the accessibility of these areas for scratching and their tendency to experience more friction and irritation during normal daily activities. Additionally, these areas often have thinner skin and may be more sensitive to environmental triggers that initiate the itch-scratch cycle characteristic of LSC. The condition develops when persistent scratching causes skin thickening (lichenification), which further intensifies itching, creating a self-perpetuating cycle that primarily manifests in these flexor regions, as discussed in recent reviews of the condition 1. Some studies have investigated the treatment of LSC, including the use of topical corticosteroids 2, 3, but the primary consideration in managing the condition is understanding its predilection for flexor surfaces. Other factors, such as psychological distress and local environmental problems, can also contribute to the development of LSC, particularly in the anogenital region 4. However, the focus on flexor regions remains a key aspect of diagnosing and treating LSC, with the goal of breaking the itch-scratch cycle and reducing morbidity and improving quality of life for affected patients. It's worth noting that while various treatments are being explored and developed for LSC, including novel therapies 2, the fundamental understanding of the condition's preference for flexor regions guides clinical approach and management decisions.