LICHEN SIMPLEX

In lichen simplex there is one (sometimes more) well-circumscribed patch
of lichenified skin which is very itchy. Lichenification means thickening of
the skin with exaggerated skin lines and this is usually caused by continuous
scratching, rubbing with a stone or stick and the likes. Patches are
commonly seen in the neck, in the genital area and on the lower legs.
Management of lichen simplex
- The vicious circle of -itch-scratch-lichenification-itch- needs to be broken.
The patient must therefore make a conscious effort to stop scratching!
- Coal tar ointment or coal tar in zinc paste applied nightly to reduce itching.
- Application of simple zinc-adhesive tape may prevent scratching and help to break
the vicious cycle.
- A strong topical steroid, especially if applied at night under plastic occlusion (e.g.
twice weekly) is usually very effective. To do this cover the lesion with plastic after
applying the steroid, then tape the sides of the plastic to surrounding skin. Do not
apply plastic occlusion in the genital area.