Lichen Simplex Chronicus

General Information
Lichen Simplex Chronicus (LSC) is considered more of a symptom than a disease. A proposed variant of LSC is lichen amyloidosis. The disorder begins when something rubs or irritates the skin and it becomes pruritic thus beginning a cycle of itching and scratching. When prolonged scratching to the affected area occurs, the skin thickens and darkens, creating further irritation. Lichen amyloidosis is described as LSC in which the keratinocytes have necrosed and formed keratinocytic-derived amyloid in the dermis. The disorder may be associated with atopic dermatitis (eczema), psoriasis, insect bites, scars and acne. It has also been know to be associated with anxiety, nervousness, depression, or other psychological disorders. Treatment is to reduce pruritus, which will minimize existing lesions. Treatment options include topical steroids, oral antianxiety medications and topical and oral antibiotics.

Epidemiology
Seen in patients with pruritic skin

Etiology
Caused by repetitive itching and scratching

Pathogenesis
Self-perpetuating scratch-itch cycle

Clinical
Skin becomes rough and brownish in the affected area

Histology
Hyperkeratosis, acanthosis, spongiosis, and patches of parakeratosis in the epidermis

Bibliography
1. “Lichen Simplex Chronicus” (Online). May 2006. http://www.emedicine.com/DERM/topic236.htm (visited: March 20, 2008) 2. “Lichen simplex chronicus” (Online). October 2006. http://www.nlm.nih.gov/medlineplus/ency/article/000872.htm (visited: March 20, 2008)

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 Lichen Simplex Chronicus