Lichen Simplex Chronicus (LSC) is actually more of a symptom than a specific disease itself. The skin eruption is created by habitually scratching a certain area over a long period of time. This scratching causes characteristic changes such as thickening and darkening of the skin, and an accentuation of normal skin lines. These changes are called lichenification.
Lichen Simplex Chronicus is seen in people with eczema. Although eczema can affect the whole body, the eruption of LSC in usually found in one area. The nerve endings in this area are irritable and trigger an itch-scratch-itch cycle. The more the eruption is scratched or rubbed, the more it itches, continuing the cycle.
Appearance of Lichen Simplex Chronicus
The following pictures show the lichen simplex chronicus rash in various locations:
Where Lichen Simplex Chronicus Occurs
The areas most commonly affected by lichen simplex chronicus are listed below in order of frequency.
- Outer lower portion of lower leg
- Wrists and ankles
- Back and side of neck (lichen simplex nuchae)
- Forearm portion of elbow
- Scrotum, vulva, anal area, pubis
- Upper eyelids
- Opening of the ear
- Fold behind the ear
Treatment of Lichen Simplex Chronicus
The most important part of treatment is understanding that all itching, rubbing, and even touching of the rash must stop. Since many people scratch in their sleep, the area may have to be covered. Lichen simplex chronicus is treated like chronic eczema by decreasing water and soap contact, and applying emollients. Topical steroids are almost always needed to control the symptoms. Since the strength of the steroids required is pretty strong, a health care provider needs to prescribe them and monitor their use. A hydrocortisone cream obtained over-the-counter can be used until an appointment is made.
