dermatologic disorders
Lichen Simplex Chronicus
Key Points
Starting with an initial itch, chronic scratching and/or rubbing causes further itching, creating a vicious circle. Itchy, dry, scaling, hyperpigmented, lichenified plaques occur in irregular, oval, or angular shapes on the legs, arms, neck, upper trunk, and the genital area. Diagnosis is clinical; a biopsy is rarely needed. The cause of the initial itch, if identifiable, must be addressed. Patients need to be educated about the vicious circle of scratching/rubbing and about how to avoid doing so repeatedly; topical corticosteroids and antihistamines help control the itching. 