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Lichen Simplex Chronicus/ Prurigo Nodularis

Written and reviewed by
Dr. Amey Kelkar 87% (64 ratings)
MD - Dermatology , Venereology & Leprosy, MBBS Bachelor of Medicine and Bachelor of Surgery
Dermatologist, Pune  •  14 years experience
Lichen Simplex Chronicus/ Prurigo Nodularis

LSC is a severely pruritic chronic disorder characterised by 1 or more lichenised plaques. Most common sites of involvement are the scalp, nape of neck, extensor aspects of extremities and anogenital regions. 

Causes:

LSC is induced by rubbing and scratching the body secondary to itch. Environmental factors like heat, sweat, irritation may also aggravate the condition. Patients with emotional lability or tension are more prone to develop this condition.

Clinical Features:

Severe itching is the hallmark of lichen simplex chronicus. Itching may be paroxysmal, sporadic or chronic. It may be conscious and to the point of replacing the sensation of itch with pain or may be unconscious occurring during sleep.

The frequent rubbing leads to development of lichenified scaly plaques. The most common sites of involvement are the nape of neck, scalp, ankles, extensor aspects of extremities and the anogenital regions. The scrotum is the common site of involvement in men. The nodules may vary in size from 0.5 mm to 3 mm.

Treatment:

Treatment is aimed at interrupting the itch scratch cycle. Systemic causes of itch should be identified and addressed. Potent topical steroids are generally prescribed to control itch. Anti histaminics like hydroxyzine or levocetrizine can also be given. Capsaicin, calcipotriol, cryotherapy have been used in the treatment of prurigo nodularis. PUVA therapy has also known to show some benefit.

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