Lichen Simplex Chronicus

Lichen Simplex Chronicus

Lichen Simplex Chronicus (LSC) is a common skin condition usually consisting of a discrete area with redness and scaling. The skin is commonly thicker and itches. These lesions are frequently found on the lower extremities and other easy-to-reach areas. They are frequently rubbed, itched or scratched by the patient. The constant scratching is an important factor in the persistence of the lesion. Many have been present for months to years and the initiating event, which may have been an injury, bug bite or contact dermatitis, is no longer causing the itch. In fact, the constant scratching and rubbing are stimulating the itch which, in turn, leads to more scratching, more itch, more scratch, a vicious cycle.

Treatment

The most important part of the treatment is to prevent further irritation (rubbing) or manipulation. Steroids thinly applied topically to the lesion two or three times a day will help to relieve the itching sensation. Covering the steroids with a band-aid or tape (Cordran tape) will both increase their penetration and protect the area from rubbing. After a few weeks of this therapy, the skin will begin to look more normal. When the skin looks almost normal you should slowly discontinue the steroid and begin using a general moisturizer of skin cream (Moisturel, Eucerin, Vaseline, etc.). This area of your skin will probably always be a little more sensitive to itching and dryness so be sure to give it special care to prevent the LSC from recurring.

Summary

• LSC is a chronic skin condition in which itching and rubbing the area plays an important part in its continued existence.
• The most important part of treatment is to try to leave the area alone.
• You will probably be given a topical steroid preparation to apply 2-3 times a day to relieve itching and inflammation.
• You may be given a steroid- containing tape to place over the area to protect it and increase the steroid effectiveness.
• When the lesion seems mostly resolved, switch from the steroid to a general moisturizer or skin cream.
• Remember to treat this area with special care as the skin will remain more sensitive for a long time.

Internet resources:

http://www.aad.org