LICHEN SIMPLEX CHRONICUS (NEURODERMATITIS)

• Lichen simplex chronicus is characterized by lichenified plaque lesion or lesions due to repeated rubbing or scratching as a habit or due to Stress
• It may occur without a predisposing dermatosis, or may follow any pruriginous dermatosis. The term Lichen Simplex is used when there is no predisposing dermatosis
• It is common in Indian subcontinent amongst adults (30 -50 years)

• May occur with or without a predisposing dermatosis
• Repeated rubbing or scratching as a habit
• Stress

• Characterized histologically by acanthosis and hyperkeratosis and clinically by thickened appearance of the skin, with accentuation of skin markings so that the affected skin resembles tree bark
• The areas most commonly affected are those that are conveniently reached. These areas are ankles and wrists, nape of neck, genitalia (scrotum and mons pubis) etc
• Lichenified plaques and excoriations are characteristic. Pruritis is the predominant symptom and is often out of proportion to the xtent of objective things
• During early stages the skin is reddened and slightly oedematous and the normal markings are exaggerated. Redness and oedema subside with time and the central area becomes scaly thickened and pigmented

Differential diagnosis

• Lichen planus
• Lichen amyloidosis
• Psoriasis

• Usually based on patient history and clinical appearance

Internal Medicines

• Patolakaturohinyadi kashaya
• Nimbanilavakadi kashaya
• Aragwadharishta + Abhayarishta
• Vilwadi gutika
• Haridra khanda
• Guggulu panchapala with Madhu

Procedures

• Neeli taila - Ext application
• Rasottamadi lepa
• Triphala + yashti choorna udgarshana
• Paranthaydi dhara