Overview
What is lichen simplex chronicus (LCS)?
What is the relationship between lichen simplex chronicus (LCS) and lichen amyloidosis?
What is the pathophysiology of lichen simplex chronicus (LCS)?
How does atopic dermatitis affect the probability of developing lichen simplex chronicus?
What are other common causes of lichen simplex chronicus?
What is the role of neurodermatitis in lichen simplex chronicus?
Which medications can trigger lichen simplex chronicus?
Can PPD in hair dye cause lichen simplex chronicus?
What is the role of long-term exposure to street traffic exhaust in lichen simplex chronicus?
What is secondary lichenification in lichen simplex chronicus?
How common is lichen simplex chronicus (LCS)?
What are the race-related demographics of lichen simplex chronicus (LCS)?
Is lichen simplex chronicus (LCS) more common in men or women?
What are the age-related demographics of lichen simplex chronicus (LCS)?
What is the prognosis of lichen simplex chronicus (LCS)?
What is the mortality of lichen simplex chronicus (LCS)?
What is the morbidity of lichen simplex chronicus (LCS)?
What causes secondary infection in lichen simplex chronicus (LCS)?
How clinically apparent is lichen simplex chronicus (LCS)?
How are patients educated about lichen simplex chronicus (LCS)?
Presentation
Where does thickening of the skin typically occur in lichen simplex chronicus (LCS)?
When is erythema noted in lichen simplex chronicus (LCS)?
How is pruritus characterized in patients with lichen simplex chronicus (LCS)?
What is the role of chronic skin conditions in lichen simplex chronicus (LCS)?
How are plaques characterized in lichen simplex chronicus (LCS)?
How are pigmentary changes characterized in the plaques of lichen simplex chronicus?
How does rubbing the skin contribute to lesion formation in lichen simplex chronicus?
What is the relationship between lichen simplex chronicus and cutaneous horns?
What behaviors may a patient exhibit during an exam for lichen simplex chronicus?
Which noncutaneous conditions are associated with lichen simplex chronicus?
DDX
What are the differential diagnoses for Lichen Simplex Chronicus?
Workup
Which lab studies are used in the workup of lichen simplex chronicus?
How is patch testing used in the workup of lichen simplex chronicus?
Which procedures are used in the workup of lichen simplex chronicus?
What histologic findings are associated with lichen simplex chronicus?
Treatment
What is the goal of lichen simplex chronicus treatment?
What is the treatment of choice for lichen simplex chronicus?
How are oral antianxiety medications and sedation used in the treatment of lichen simplex chronicus?
When are antibiotics indicated in the treatment of lichen simplex chronicus?
When is topical aspirin/dichloromethane indicated in the treatment of lichen simplex chronicus?
What is the role of botulinum toxin injections in the treatment of lichen simplex chronicus?
When is consultation with a dermatologist indicated in the treatment of lichen simplex chronicus?
When is consultation with an allergist indicated in the treatment of lichen simplex chronicus?
When is consultation with a psychiatrist indicated in the treatment of lichen simplex chronicus?
How does the prevention of scratching help the treatment of lichen simplex chronicus?
How do extreme temperatures, humidity, and stress affect the treatment of lichen simplex chronicus?
What is the long-term monitoring in patients with lichen simplex chronicus?
Medications
What are the goals of drug treatment for lichen simplex chronicus?
-
Plaque of lichen simplex chronicus demonstrating accentuated skin markings. Courtesy of San Antonio Uniformed Services Health Education Consortium Dermatology Program.
-
Area of lichen simplex chronicus originally believed to be chronic contact dermatitis. The true nature was revealed when the patient admitted to rubbing this area while watching television. Courtesy of San Antonio Uniformed Services Health Education Consortium Dermatology Program.
-
Plaques of lichen simplex chronicus on the hand.
-
Lichen simplex chronicus of the dorsal hand and wrist demonstrating increased skin thickness and accentuation of skin markings.
-
Plaque of lichen simplex chronicus of the leg with accentuated skin markings and excoriations.
-
H and E biopsy of lichen simplex chronicus from forearm skin viewed at 40x magnification. Note the characteristic hyperkeratosis, hypergranulosis, pseudoepitheliomatous hyperplasia, and papillary dermal fibrosis.
-
H and E biopsy of lichen simplex chronicus from forearm skin viewed at 100x magnification. Note the characteristic hyperkeratosis, hypergranulosis, pseudoepitheliomatous hyperplasia, and papillary dermal fibrosis.