Lichen simplex chronicus

Classification according to ICD-10
L28.0	Lichen simplex chronicus
ICD-10 online (WHO version 2019)

Lichen simplex chronicus is a local, chronic inflammatory, plaque-shaped and lichinoid (nodular) skin disease that runs in bouts and is accompanied by severe itching. It is also known under the names Neurodermitis cirumscripta , Lichen Chronicus Vidal or Vidal's disease .

Symptoms

Lichen simplex chronicus manifests itself as a strong local itch that cannot be alleviated by scratching. Hemp-sized, hard and reddish-brown or skin-colored papules form , which lead to extensive skin thickening ( lichenification ). The neck region, the extensor sides of the forearms and lower legs, the sacrum and the genital area are preferably affected. Mental stress or stress can worsen the disease or even cause it to recur. Lichen simplex chronicus is always chronic.

Recurrence of lichen simplex chronicus on the shin

Lichen simplex chronicus on the forearm

Lichen simplex chronicus on the ankle

causes

The causes of lichen simplex chronicus have not yet been clarified. A negative variant of atopic eczema is being discussed . But apparently psychological factors also play a role. The fact is that any irritation of the skin will aggravate the foci of lichen. The biggest problem is scratching. A chain reaction occurs. The itching that occurs is tried to calm by scratching, which means that the itching reappears more intensely.

diagnosis

Histological section of a skin biopsy for lichen simplex chronicus

The diagnosis is made on the one hand from the symptoms ( itching , lichenification and chronic course ), on the other hand from the histology . A tissue sample is taken from the changed area as part of a biopsy and examined histologically. Lichen simplex chronicus can be safely diagnosed in this way. Possible differential diagnoses should be considered in advance , e.g. B. allergic contact eczema , atopic eczema or lichen planus .

therapy

Since lichen simplex chronicus is a chronic disease for which the causes and triggers are unknown, long-term therapy is essential. In addition, the disease proves to be extremely resistant to therapy. It is treated with ointments containing cortisone , which are usually used under occlusive dressings . Antihistamines can be used against the itching . Good results can also be achieved with the help of phototherapy or PUVA therapy. The patient should be careful not to cover the affected parts of the body with clothing, because solar radiation and ventilation of the pathologically altered skin have a beneficial effect on healing. Care should also be taken not to cause unnecessary skin irritation (e.g. from hard, scratchy bath sponges or perfumed shower gel). Even if a lichen simplex chronicus focus has completely healed, the likelihood of it recurring in the same area after six to twelve months is high. Since the severe itching that occurs can considerably reduce the quality of life depending on the extent of the disease, it is advisable to provide psychosomatic care for the patient.

Sources and web links

Commons : Lichen simplex chronicus  - collection of images, videos and audio files

1. Peter Altmeyer: Encyclopedia Dermatology: Article on Lichen simplex chronicus (online) Springer 2017
2. DermIS [1]

Individual evidence

1. ↑ Peter Reuter: Springer Lexicon Medicine. Springer, Berlin a. a. 2004, ISBN 3-540-20412-1 , p. 1246.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !