Lichen simplex chronicus

Lichen simplex chronicus, neurodermatitis with lichenification, is a circumscribed plaque of pruritic skin with accentuated skin markings.
Usually it begins as a patch of eczema, which upon being chronically excoriated becomes a thickened (lichenified) plaque.
There can actually be cutaneous nerve proliferation within this plaque, seeming to lead to further pruritus, with further excoriation and therefore further thickening and extension of the plaque.
Typical areas for lichen simplex chronicus are the lower leg and lateral neck, but this reaction can occur anywhere where there is chronic rubbing.

Treatment:

• Intra-lesional corticosteroids given weekly can be beneficial
• Corticosteroids under occlusion such as that with Cordran tape is effective
• Doxepin cream, capsaicin cream can be helpful as adjunctive therapy

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