Lichen simplex chronicus

Lichen simplex chronicus

The term lichen simplex chronicus (circumscribed neurodermatitis) refers to the development of localized areas of thickened scaly skin complicating prolonged and severe scratching in a patient with no underlying dermatological condition. Lichenification is an identical process in which an underlying intensely pruritic dermatosis such as atopic eczema is present. Dermatophyte infections, stasis dermatitis, and chronic allergic contact dermatitis may also predispose to lichenification. picker's nodules and nodular prurigo are related conditions.

Patients present with profound pruritus and localized scaly plaques with accentuated skin markings described as resembling tree bark. there is a predilection for females, and young to middle-aged adults are predominantly affected. accessible skin is particularly affected and the nape and sides of the neck, the thighs, the lower legs and ankles, vulva, and scrotum are sites generally involved.

Pebbly lichenification refers to a distinct variant in which lichenoid papules follow intense scratching in patients with inflammatory dermatoses such as atopic eczema.

Source: P. McKee, J. Calonje - McKee's Pathology of the Skin (Elsevier)

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