Highlights & Basics
- Lichen simplex chronicus may occur as a primary process with no underlying dermatosis or as a secondary process due to an underlying pruritic dermatosis (such as atopic dermatitis or allergic contact dermatitis) or a systemic condition causing pruritus.
- Underlying psychological comorbidities may be present including depression, anxiety disorder, or obsessive-compulsive disorder.
- A difficult to manage and often recurring condition that is treated with potent topical corticosteroids and sedating antihistamines.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Secondary lichen simplex chronicus in the setting of atopic dermatitis
Secondary lichen simplex chronicus in the setting of atopic dermatitis
Low-power photomicrograph of lichen simplex chronicus (hematoxylin-eosin stain, x40)
Medium-power photomicrograph of lichen simplex chronicus (hematoxylin-eosin stain, x100)
High-power photomicrograph of lichen simplex chronicus (hematoxylin-eosin stain, x200)
Citations
Lotti T, Buggaiani G, Prignano F. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther. 2008;21:42-46.[Abstract][Full Text]
Primary Care Dermatology Society. Lichen simplex (syn. circumscribed neurodermatitis). Jun 2022 [internet publication].[Full Text]
van der Meijden WI, Boffa MJ, Ter Harmsel B, et al. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2022 Jul;36(7):952-72.[Abstract][Full Text]
American College of Obstetricians and Gynecologists. Practice bulletin no. 224: diagnosis and management of vulvar skin disorders. Jul 2020 [internet publication].[Full Text]
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7. Primary Care Dermatology Society. Lichen simplex (syn. circumscribed neurodermatitis). Jun 2022 [internet publication].[Full Text]
8. Liao YH, Lin CC, Tsai PP, et al. Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort study. Br J Dermatol. 2014;170:890-894.[Abstract]
9. Konuk N, Koca R, Atik L, et al. Psychopathology, depression and dissociative experiences in patients with lichen simplex chronicus. Gen Hosp Psychiatry. 2007;29:232-235.[Abstract]
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12. James WD, Berger TG, Elston DM. Andrews' diseases of the skin: clinical dermatology, 10th ed. Philadelphia, PA:. Elsevier; 2006.
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14. Crone AM, Stewart EJ, Wojnarowska F, et al. Aetiological factors in vulvar dermatitis. J Eur Acad Dermatol Venereol. 2000;14:181-186.[Abstract]
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16. Yalçın M, Baş A, Ergelen M, et al. Psychiatric comorbidity and temperament-character traits of the patients with lichen simplex chronicus: the relation with the symptom severity of the disease. Dermatol Ther. 2020 Nov;33(6):e14389.[Abstract]
17. van der Meijden WI, Boffa MJ, Ter Harmsel B, et al. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2022 Jul;36(7):952-72.[Abstract][Full Text]
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22. American College of Obstetricians and Gynecologists. Practice bulletin no. 224: diagnosis and management of vulvar skin disorders. Jul 2020 [internet publication].[Full Text]
23. Jerajani HR, Melkote S. Thin-layer rapid-use epicutaneous test (TRUE test). Indian J Dermatol Venereol Leprol. 2007;73:292-295.[Abstract][Full Text]
24. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens. J Am Acad Dermatol. 1998;38:911-918.[Abstract]
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29. Aschoff R, Wozel G. Topical tacrolimus for the treatment of lichen simplex chronicus. J Dermatolog Treat. 2007;18:115-117.[Abstract]
30. Goldstein AT, Parneix-Spake A, McCormick CL, et al. Pimecrolimus cream 1% for treatment of vulvar lichen simplex chronicus: an open-label, preliminary trial. Gynecol Obstet Invest. 2007;64:180-186.[Abstract]
31. Tan ES, Tan AS, Tey HL. Effective treatment of scrotal lichen simplex chronicus with 0.1% tacrolimus ointment: an observational study. J Eur Acad Dermatol Venereol. 2015;29:1448-1449.[Abstract]
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38. Corazza M, Borghi A, Minghetti S, et al. Effectiveness of silk fabric underwear as an adjuvant tool in the management of vulvar lichen simplex chronicus: results of a double-blind randomized controlled trial. Menopause. 2015 Jan 20 [Epub ahead of print].[Abstract]
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42. Shenefelt PD. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind? Dermatol Ther. 2003;16:114-122.[Abstract]
43. Rosenbaum MS, Ayllon T. The behavioral treatment of neurodermatitis through habit-reversal. Behav Res Ther. 1981;19:313-318. [Abstract]
44. Lehman RE. Brief hypnotherapy of neurodermatitis: a case with 4-year followup. Am J Clin Hypn. 1978;21:48-51.[Abstract]
45. Harris BA, Sherertz EF, Flowers FP. Improvement of chronic neurotic excoriations with oral doxepin therapy. Int J Dermatol. 1987;26:541-543.[Abstract]
46. Langley RG, Luger TA, Cork MJ, et al. An update on the safety and tolerability of pimecrolimus cream 1%: evidence from clinical trials and post-marketing surveillance. Dermatology. 2007;215(suppl 1):27-44. [Abstract]
47. Tupker RA, Coenraads PJ, van der Meer JB. Treatment of prurigo nodularis, chronic prurigo and neurodermatitis circumscripta with topical capsaicin. Acta Derm Venereol. 1992;72:463.[Abstract]
48. Drake LA, Millikan LE. The antipruritic effect of 5% doxepin cream in patients with eczematous dermatitis. Doxepin Study Group. Arch Dermatol. 1995;131:1403-1408.[Abstract]
49. Taylor JS, Praditsuwan P, Handel D, et al. Allergic contact dermatitis from doxepin cream. One-year patch test clinic experience. Arch Dermatol. 1996;132:515-518.[Abstract]
50. McDow RA, Wester MM. Cryosurgical treatment of nodular neurodermatitis with Refrigerant 12. J Dermatol Surg Oncol. 1989;15:621-623.[Abstract]
51. Ling TC, Clayton TH, Crawley J, et al. British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen-ultraviolet A therapy 2015. Br J Dermatol. 2016 Jan;174(1):24-55.[Abstract][Full Text]
52. Heckmann M, Heyer G, Brunner B, et al. Botulinum toxin type A injection in the treatment of lichen simplex: an open pilot study. J Am Acad Dermatol. 2002;46:617-619.[Abstract]
53. Gharib K, Mostafa A, Elsayed A. Evaluation of botulinum toxin type A injection in the treatment of localized chronic pruritus. J Clin Aesthet Dermatol. 2020 Dec;13(12):12-17.[Abstract][Full Text]
54. Yang L, Li X, Huang W, et al. The Efficacy and safety of acupuncture in the treatment of neurodermatitis: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2022;2022:8182958.[Abstract][Full Text]
55. Gencoglan G, Inanir I, Gunduz K. Therapeutic hotline: treatment of prurigo nodularis and lichen simplex chronicus with gabapentin. Dermatol Ther. 2010;23:194-198.[Abstract]
56. Yosipovitch G, Sugeng MW, Chan YH, et al. The effect of topically applied aspirin on localized circumscribed neurodermatitis. J Am Acad Dermatol. 2001 Dec;45(6):910-3.[Abstract]
57. Lee HG, Grossman SK, Valdes-Rodriguez R, et al. Topical ketamine-amitriptyline-lidocaine for chronic pruritus: a retrospective study assessing efficacy and tolerability. J Am Acad Dermatol. 2017 Apr;76(4):760-1.[Abstract][Full Text]
58. Vaidya DC, Schwartz RA. Prurigo nodularis: a benign dermatosis derived from a persistent pruritus. Acta Dermatovenerol Croat. 2008;16:38-44.[Abstract]
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