Lichen simplex chronicus

Definition

Lichen simplex chronicus (LSC) is a skin condition caused by chronic itching and scratching.

Alternative Names

LSC; Neurodermatitis circumscripta

Causes

LSC may occur in people who have:

The problem is common in adults but may also be seen in children.

Symptoms

LSC leads to scratching, which then causes more itching. It often follows this pattern:

Symptoms include:

Exams and Tests

Your health care provider will look at your skin and ask if you have had chronic itching and scratching in the past. A skin lesion biopsy may be done to confirm the diagnosis.

Treatment

The main treatment is to reduce the itch.

You may need to use these medicines on your skin:

You may need to use dressings that moisturize, cover, and protect the area. These may be used with or without medicated creams. They are left in place for a week or more at a time. Wearing cotton gloves at night may prevent skin damage from scratching.

To control itching and stress, you may need to take medicines by mouth, such as:

Steroids may be injected directly into the skin patches to reduce itching and irritation.

You may need to take antidepressants and tranquilizers if the cause of your itching is emotional. Other measures include:

Outlook (Prognosis)

You can control LSC by reducing itch and controlling scratching. While the condition can be treated, it often returns. The condition may return or move to different areas on the skin. Ongoing management can help relieve symptoms.

Possible Complications

These complications of LSC can occur:

When to Contact a Medical Professional

Contact your provider if:

References

Dinulos JGH. Eczema and hand dermatitis. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 3.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Pruritus and neurocutaneous dermatoses. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 4.

Patterson JW. The psoriasiform reaction pattern. In: Patterson JW, ed. Weedon's Skin Pathology. 5th ed. Philadelphia, PA: Elsevier Limited; 2021:chap 5.

Renzi MA, Sommer LL, Baker DJ. Lichen simplex chronicus. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier, 2022:chap 138.

Zug KA. Eczema. In: Habif TP, Dinulos JGH, Chapman MS, Zug KA, eds. Skin Disease: Diagnosis and Treatment. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 2.



Review Date: 11/18/2022
Reviewed By: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update: 06/13/2024.
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