El sindrome de Neurodermatitis, o Liquen Simple Cronico. !
The Neurodermatitis Syndrome or Lichen Simplex Chronicus. !
NEURODERMATITIS DEL TOBILLO
PUBLICADO 2.017 ACTUALIZADO 2.023
EDITORIAL ESPAÑOL
=================
Hola amigos de la red, DERMAGIC EXPRESS hoy con un tema bastante interesante: EL SINDROME DE NEURODERMATITIS, también conocido como LIQUEN SIMPLE CRONICO (LSC). Algunos autores incluyen esta patología dentro del capítulo de LA DERMATITIS ATOPICA, como una variante de ella.
Pero LA NEURODERMATITIS o LIQUEN SIMPLE CRONICO, tienen un conjunto de signos y santonas que permiten denominarlo como EL SINDROME DE NEURODERMATITIS, y ellos son:
1.) PRURITO INTENSO EN AREAS AFECTADAS, PREFERIBLEMENTE DE NOCHE.
2.) AFECTA POR IGUAL ADULTOS MASCULINOS Y FEMENINOS ENTRE 35 Y 50 AÑOS O MAS.
3.) AREAS MAS COMUNMENTE AFECTADAS:
A.) MIEMBROS INFERIORES.
B.) VULVA.
C.) ESCROTO.
D.) REGION PERIANAL.
E.) CUELLO.
Pero puede presentarse en cualquiera área de la piel como ZONAS FLEXURALES, ESPALDA, DORSO DE PIE y otras.
=================
Hola amigos de la red, DERMAGIC EXPRESS hoy con un tema bastante interesante: EL SINDROME DE NEURODERMATITIS, también conocido como LIQUEN SIMPLE CRONICO (LSC). Algunos autores incluyen esta patología dentro del capítulo de LA DERMATITIS ATOPICA, como una variante de ella.
Pero LA NEURODERMATITIS o LIQUEN SIMPLE CRONICO, tienen un conjunto de signos y santonas que permiten denominarlo como EL SINDROME DE NEURODERMATITIS, y ellos son:
1.) PRURITO INTENSO EN AREAS AFECTADAS, PREFERIBLEMENTE DE NOCHE.
2.) AFECTA POR IGUAL ADULTOS MASCULINOS Y FEMENINOS ENTRE 35 Y 50 AÑOS O MAS.
3.) AREAS MAS COMUNMENTE AFECTADAS:
A.) MIEMBROS INFERIORES.
B.) VULVA.
C.) ESCROTO.
D.) REGION PERIANAL.
E.) CUELLO.
Pero puede presentarse en cualquiera área de la piel como ZONAS FLEXURALES, ESPALDA, DORSO DE PIE y otras.
NEURODERMATITIS PIERNA
5.) ANTECEDENTES DE ALERGIA EN LOS AFECTADOS: DERMATITIS POR CONTACTO, ATOPIA, RINITIS, SINUSITIS, ASMA.
La enfermedad puede comenzar con un EVENTO PRIMARIO como: simple roce de la tela de la ropa con la piel, contacto con algún irritante, perfumes en la piel, cremas cosméticas de mala calidad, afeitado de las piernas.
Este primer evento provoca COMEZON O PRURITO y la persona comienza a rascarse el área afectada, SIENDO ESTE EL SEGUNDO EVENTO y quizá el mas importante en esta enfermedad. El prurito se vuelve "INSOPORTABLE" y los pacientes recurren a REMEDIOS CASEROS Y CREMAS INADECUADAS, que empeoran la piel, la cual adquiere un aspecto engrosado.
EL TERCER EVENTO lo constituye la formación de LA LESION, la cual comienza por ser una placa eritematoescamosa circunscrita, la cual a medida que el paciente se rasca se va agrandando, y posteriormente en muchos casos la lesión se infecta convirtiéndose en una ENFERMEDAD CRONICA, pues el paciente no deja de rascarse. De allí el nombre de LIQUEN SIMPLE CRONICO, que significa LESION SIMPLE CRONICA DE LA PIEL.
NEURODERMATITIS DE LA ESPALDA CON SIGNOS DE RASCADO
La palabra LIQUEN, viene del término LIQUENIFICACION, que significa ENGROSAMIENTO DE LA PIEL, y ello se produce por el rascado continuo de la misma.
La mayoría de los pacientes va a la consulta diciendo que padece de "HONGO" y empeora sus lesiones por colocarse cremas inadecuadas, además de "inventos caseros" como hierbas, alcohol, jabón azul, creolina, etc.
El común denominador de estos pacientes es el ESTRES Y deseo incontrolable por rascarse la piel, por ello algunos autores incluyen esta patología dentro de las PSICODERMATOSIS, ya que la consideran de origen PSICOSOMATICO.
El mejor término que se le puede dar al LIQUEN SIMPLE CRONICO es el de SINDROME DE NEURODERMATITIS, quizá como una variante de la DERMATITIS ATOPICA, porque sus signos y síntomas son bien específicos.
El tratamiento del LIQUEN SIMPLE CRONICO o NEURODERMATITIS debe estar dirigido a "CORTAR" EL CICLO DEL RASCADO, una vez hecho esto más un buen tratamiento TOPICO, las lesiones desaparecen la mayoría de las veces sin dejar secuela.
LIQUEN AMILOIDE DE LA ESPALDA PRODUCTO DE CONTINUO RASCADO POR
NEURODERMATITIS PREVIA
En algunos casos el daño ocasionado a la piel deja secuelas
principalmente marcas HIPERPIGMENTADAS. En casos muy crónicos. La
piel toma un aspecto amarillento por la deposición de una
sustancia llamada AMILOIDE, siendo entonces denominado LIQUEN AMILODE, el cual también es consecuencia del rascado, y no está
relacionado con la enfermedad AMILOIDOSIS CUTIS la cual es
sistémica. Es importante que sepas esto.
LOS TRATAMIENTOS MAS UTILIZADOS PARA LA NUERODERMATITIS SON:
1.) ANTIHISTAMINICOS.
2.) ESTEROIDES TOPICOS.
3.) UREA.
4 ) ACIDO SALICILICO.
5.) HIDRATANTES.
6.) ANTIDEPRESIVOS, EN CASOS SEVEROS.
7.) PIMECROLIMUS Y TACROLIMUS. ( Estas dos medicinas hoy día llevan en su empaque una CAJA NEGRA O BLACK BOK, advertencia de SEGURIDAD mas grave en los EE.UU, porque a largo plazo pueden producir cáncer)
LOS TRATAMIENTOS MAS UTILIZADOS PARA LA NUERODERMATITIS SON:
1.) ANTIHISTAMINICOS.
2.) ESTEROIDES TOPICOS.
3.) UREA.
4 ) ACIDO SALICILICO.
5.) HIDRATANTES.
6.) ANTIDEPRESIVOS, EN CASOS SEVEROS.
7.) PIMECROLIMUS Y TACROLIMUS. ( Estas dos medicinas hoy día llevan en su empaque una CAJA NEGRA O BLACK BOK, advertencia de SEGURIDAD mas grave en los EE.UU, porque a largo plazo pueden producir cáncer)
Es importante que sepas que en muchos casos LA NEURODERMATITIS se inicia como una ALERGIA POR CONTACTO a una sustancia especifica, calzado, cuero o tela, y al instalarse el CICLO RASCADO - ENGROSAMIENTO DE LA PIEL - RASCADO, queda tipificada la enfermedad, separándose de LA DERMATITIS POR CONTACTO o ATOPIA, quienes por lo general fueron los desencadenantes.
Dato final para todos los pacientes quienes padecen de LIQUEN SIMPLE CRONICO o NEURODERMATITIS:
“…… MIENTRAS MAS TE RASQUES LA PIEL , mas ENFROSAMIENTO Y DAÑO DE LA MISMA y MAS COMENZON, lo que provocara MAS RASCADO… un circulo vicioso del cual solo se saldrá DEJANDO DE RASCAR LA PIEL…..” De modo que:
Necesitas un buen tratamiento en dos AREAS: PARA EL PRURITO O COMEZON, y TOPICO para la piel.
En las referencias los hechos en las fotos varios tipos DE LIQUEN SIMPLE CRONICO
Saludos a todos.
Dr. José Lapenta
===================
Hello friends of the network, DERMAGIC EXPRESS today with a very
interesting topic: THE NEURODERMATITIS SYNDROME, also known as
LICHEN SIMPLEX CHRONICUS
(LSC). Some authors include this pathology within the chapter on ATOPIC
DERMATITIS, as a variant of it.
But NEURODERMATITIS or LICHEN SIMPLEX CHRONICUS have a set of signs and symptoms that allow to denominate it like THE NEURODERMATITIS SYNDROME, and they are:
1.) INTENSE PRURITUS IN AFFECTED AREAS, PREFERABLY NIGHT.
2.) AFFECTS FOR THE SAME MALE AND FEMALE ADULTS BETWEEN 35 AND 50 YEARS OR MORE.
3.) AREAS MORE COMMONLY AFFECTED:
A.) LOWER LIMBS.
B.) VULVA.
C.) SCROTUM.
D. PERIANAL REGION.
E.) NECK.
But it can appear in any area of the skin like FLEXURIAL ZONES, BACK, FOOT and others.
4.) THERE IS A PSYCHOLOGICAL COMPONENT IN THE AFFECTED: STRESS, INCORMATION WITH ANY AREA OF THE BODY.
5.) BACKGROUND OF ALLERGY IN THE AFFECTED: CONTACT DERMATITIS, ATOPIA, RHINITIS, SINUSITIS, ASTHMA.
The disease can begin with a PRIMARY EVENT such as: simple rubbing of the clothing with the skin, contact with some irritant, perfume or fragrance on the skin, poor cosmetic creams, shaving of the legs.
This first event causes ITCHING OR PRURITUS and the person begins to scratch the affected area, BEING THIS THE SECOND EVENT and perhaps the most important in this disease. Pruritus becomes "INSUPPORTABLE" and patients appeal to HOME REMEDIES and IMPROPERED CREAMS, which worsen the skin, which becomes thickened.
THE THIRD EVENT is the formation of THE LESION which begins as a circumscribed erythematous-squamous plaque, which, as the patient scratches, enlarges, and in many cases, the lesion becomes infected, becoming a CHRONIC DISEASE. The patient does not stop scratching. Hence the name LICHEN SIMPLEX CHRONICUS, which means SIMPLE AND CHRONIC LESION OF THE SKIN.
The word LICHEN comes from
the term LICHENIFIED, which means
THICKENING OF THE SKIN, and this is produced by the continuous scratching of it.
The most affected areas in medical practice are in women: the VULVAR region, LOWER LIMBS AND PERIANAL REGION. In the man: SCROTUM, LOWER LIMBS AND PERIANAL REGION.
Most patients go to the office saying that they have "FUNGUS" and worsen their injuries by placing inappropriate creams, besides "homemade inventions" such as herbs, alcohol, blue soap, creoline etc.
The common denominator of these patients is the STRESS and uncontrollable desire to scratch the skin, so some authors include this pathology within PSYCHODERMATOSES, since they consider it of PSYCHOSOMATIC origin.
The best term that can be given to LICHEN SIMPLEX CHRONICUS is the NEURODERMATITIS SYNDROME, perhaps as a variant of ATOPIC DERMATITIS, because its signs and symptoms are very specific.
The treatment of LICHEN SIMPLEX CHRONICUS or NEURODERMATITIS should be directed to "CUT" THE CYCLE OF THE SCRATCH, once this is done plus a good TOPICAL treatment, the lesions disappear most of the time without leaving a sequel.
In some cases the damage caused to the skin leaves sequels mainly HYPERPIGMENTED marks. In very chronic cases. The skin takes on a yellowish appearance by the deposition of a substance called AMYLOID, which is then called LICHEN AMYLODOSUS, which is also a consequence of scratching, and is not related to the AMYLOIDOSUS CUTIS disease, which is systemic. It is important that you know this.
THE MOST UTILIZED TREATMENTS FOR NUERODERMATITIS ARE:
1.) ANTIHISTAMINICS.
2.) TOPICAL STEROIDS.
3.) UREA.
4) SALICYLIC ACID.
5.) MOISTURIZERS.
6.) ANTIDEPRESSIVE, IN SEVERE CASES.
7.) PIMECROLIMUS AND TACROLIMUS. (These two medicines today have a BLACK BOX or on their packaging, a more serious SAFETY warning in the US, because in the long term they can cause cancer)
It is important that you know that in many cases NEURODERMATITIS starts as an ALLERGY BY CONTACTING a specific substance, footwear, leather, or clothes, and when the CYCLE SCRATCHING - THICKENED SKIN - MORE SCRATCHING, it is produced, the disease is defined, separating from CONTAC DERMATITIS or ATOPIA, who were usually the triggers.
Final data for all patients suffering from LICHEN SIMPLEX CHRONICUS or NEURODERMATITIS:
"...... WHILE YOU SCRATCH THE SKIN, MORE THICKENED BECOME, CAUSING MORE ITCHING , which will cause MORE SCRATCHING... a vicious circle from which will only come out LEAVING TO SCRATCH THE SKIN ...." So that:"
You need a good treatment in two WAYS: FOR THE PRURITUS OR ITCHING, and TOPICAL for the skin.
In the references the facts in the photos several types LICHEN SIMPLEX CHRONICUS
Greetings to all.
Dr. José Lapenta
But NEURODERMATITIS or LICHEN SIMPLEX CHRONICUS have a set of signs and symptoms that allow to denominate it like THE NEURODERMATITIS SYNDROME, and they are:
1.) INTENSE PRURITUS IN AFFECTED AREAS, PREFERABLY NIGHT.
2.) AFFECTS FOR THE SAME MALE AND FEMALE ADULTS BETWEEN 35 AND 50 YEARS OR MORE.
3.) AREAS MORE COMMONLY AFFECTED:
A.) LOWER LIMBS.
B.) VULVA.
C.) SCROTUM.
D. PERIANAL REGION.
E.) NECK.
But it can appear in any area of the skin like FLEXURIAL ZONES, BACK, FOOT and others.
4.) THERE IS A PSYCHOLOGICAL COMPONENT IN THE AFFECTED: STRESS, INCORMATION WITH ANY AREA OF THE BODY.
5.) BACKGROUND OF ALLERGY IN THE AFFECTED: CONTACT DERMATITIS, ATOPIA, RHINITIS, SINUSITIS, ASTHMA.
The disease can begin with a PRIMARY EVENT such as: simple rubbing of the clothing with the skin, contact with some irritant, perfume or fragrance on the skin, poor cosmetic creams, shaving of the legs.
This first event causes ITCHING OR PRURITUS and the person begins to scratch the affected area, BEING THIS THE SECOND EVENT and perhaps the most important in this disease. Pruritus becomes "INSUPPORTABLE" and patients appeal to HOME REMEDIES and IMPROPERED CREAMS, which worsen the skin, which becomes thickened.
THE THIRD EVENT is the formation of THE LESION which begins as a circumscribed erythematous-squamous plaque, which, as the patient scratches, enlarges, and in many cases, the lesion becomes infected, becoming a CHRONIC DISEASE. The patient does not stop scratching. Hence the name LICHEN SIMPLEX CHRONICUS, which means SIMPLE AND CHRONIC LESION OF THE SKIN.
The most affected areas in medical practice are in women: the VULVAR region, LOWER LIMBS AND PERIANAL REGION. In the man: SCROTUM, LOWER LIMBS AND PERIANAL REGION.
Most patients go to the office saying that they have "FUNGUS" and worsen their injuries by placing inappropriate creams, besides "homemade inventions" such as herbs, alcohol, blue soap, creoline etc.
The common denominator of these patients is the STRESS and uncontrollable desire to scratch the skin, so some authors include this pathology within PSYCHODERMATOSES, since they consider it of PSYCHOSOMATIC origin.
The best term that can be given to LICHEN SIMPLEX CHRONICUS is the NEURODERMATITIS SYNDROME, perhaps as a variant of ATOPIC DERMATITIS, because its signs and symptoms are very specific.
The treatment of LICHEN SIMPLEX CHRONICUS or NEURODERMATITIS should be directed to "CUT" THE CYCLE OF THE SCRATCH, once this is done plus a good TOPICAL treatment, the lesions disappear most of the time without leaving a sequel.
In some cases the damage caused to the skin leaves sequels mainly HYPERPIGMENTED marks. In very chronic cases. The skin takes on a yellowish appearance by the deposition of a substance called AMYLOID, which is then called LICHEN AMYLODOSUS, which is also a consequence of scratching, and is not related to the AMYLOIDOSUS CUTIS disease, which is systemic. It is important that you know this.
THE MOST UTILIZED TREATMENTS FOR NUERODERMATITIS ARE:
1.) ANTIHISTAMINICS.
2.) TOPICAL STEROIDS.
3.) UREA.
4) SALICYLIC ACID.
5.) MOISTURIZERS.
6.) ANTIDEPRESSIVE, IN SEVERE CASES.
7.) PIMECROLIMUS AND TACROLIMUS. (These two medicines today have a BLACK BOX or on their packaging, a more serious SAFETY warning in the US, because in the long term they can cause cancer)
It is important that you know that in many cases NEURODERMATITIS starts as an ALLERGY BY CONTACTING a specific substance, footwear, leather, or clothes, and when the CYCLE SCRATCHING - THICKENED SKIN - MORE SCRATCHING, it is produced, the disease is defined, separating from CONTAC DERMATITIS or ATOPIA, who were usually the triggers.
Final data for all patients suffering from LICHEN SIMPLEX CHRONICUS or NEURODERMATITIS:
"...... WHILE YOU SCRATCH THE SKIN, MORE THICKENED BECOME, CAUSING MORE ITCHING , which will cause MORE SCRATCHING... a vicious circle from which will only come out LEAVING TO SCRATCH THE SKIN ...." So that:"
You need a good treatment in two WAYS: FOR THE PRURITUS OR ITCHING, and TOPICAL for the skin.
In the references the facts in the photos several types LICHEN SIMPLEX CHRONICUS
Greetings to all.
Dr. José Lapenta
Dr. José M. Lapenta
==========================================================================
REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES
=========================================================================
1.) [Neurodermatitis : Atopy of the skin].
2.) Differences Between Men and Women in Chronic Scratching: A
Psychodermatologic Study in Lichen Simplex Chronicus.
3.) Personality differences between patients with lichen simplex chronicus and normal population: A study of pruritus.
4.) Sleep disturbance in patients with lichen simplex chronicus and its relationship to nocturnal scratching: A case control study.
5.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
6.) Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort study.
7.) Emotions and skin (II)-the conditioning of scratch responses in cases of lichen simplex.
8.) Lichen simplex chronicus - A Psychocutaneous disorder?
9.) Lichen simplex chronicus as a symptom of neuropathy.
10.) Clinical, epidemiological and therapeutic profile of patients with brachioradial pruritus in a reference service in dermatology.
11.) Study of pruritus vulvae in geriatric age group in tertiary hospital.
12.) Lichenoid vulvar disease: A review.
13.) Lichen simplex chronicus of the eyelid.
14.) Lichen amyloidosus: a consequence of scratching.
15.) Managing vulvar lichen simplex chronicus.
16.) Prurigo nodularis and lichen simplex chronicus.
17.) [Lichen amyloidosus--disease entity or the effect of scratching].
18.) Clinical Study of 124 Patients Having Perianal Dermatitis.
19.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
20.) Antidepressants have Anti-inflammatory Effects that may be Relevant to Dermatology: A Systematic Review.
21.) [Risk hidden in the small print? : Some food additives may trigger pseudoallergic reactions].
22.) [Introduction neurodermatitis and urea].
23.) [The use of H-1 antihistamine preparations in neurodermatitis patients].
24.) Acupuncture as a Treatment Modality in Dermatology: A Systematic Review.
25.) Use of transcutaneous electrical nerve stimulation for chronic pruritus.
26.) Dermatopathology in historical perspective: the Montgomery giant cell of lichen simplex chronicus.
14.) Perianal lichen dermatoses: A review of 60 cases. =============================================================
===========================================================
1.) [Neurodermatitis : Atopy of the skin].
===========================================================
Ophthalmologe. 2017 Apr 26. doi: 10.1007/s00347-017-0495-x. [Epub ahead of print]
[Article in German]
Fölster-Holst R1.
Author information
1
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 7, 24105, Kiel, Deutschland. rfoelsterholst@dermatology.uni-kiel.de.
Abstract
Atopic dermatitis is one of the most common skin diseases and is associated with an impaired quality of life due to tormenting itching and stigmatization. The disease almost always manifests in early childhood and exhibits specific features in this phase, with involvement of the extensor sides of the extremities. During the further course of disease, the typical flexor involvement becomes quite clear and a considerable proportion of patients develop the associated atopic respiratory diseases. Therapeutic and prophylactic measures focus on the prevention of trigger factors, basic skin care, and application of lipid-replenishing creams, as well as patient and parent education. In the case of exacerbation, anti-inflammatory drugs are treatment of choice.
===========================================================
2.) Differences Between Men and Women in Chronic Scratching: A Psychodermatologic Study in Lichen Simplex Chronicus.
===========================================================
Actas Dermosifiliogr. 2017 May;108(4):354-360. doi: 10.1016/j.ad.2016.12.002. Epub 2017 Feb 2.
[Article in English, Spanish]
Martín-Brufau R1, Suso-Ribera C2, Brufau Redondo C3, Corbalán Berná J4.
Author information
1
Faculty of Psychology, University of Murcia, Spain. Electronic address: ramonmail@gmail.com.
2
Faculty of Psychology, University of Barcelona, Spain.
3
Service of Dermatology, Hospital Reina Sofía, Murcia, Spain; Faculty of Medicine, University of Murcia, Spain.
4
Faculty of Psychology, University of Murcia, Spain.
Abstract
INTRODUCTION:
Chronic scratching is common to many skin disorders. Being a female and presenting a high level of psychopathology are risk factors for chronic scratching. Yet, it is unclear why. Certain personality characteristics that are more prevalent in women are also known to influence emotional states (i.e. emotional tension).
OBJECTIVE:
The present study aims to explore whether these personality styles might help understand why gender and emotional distress are associated with scratching.
MATERIAL AND METHODS:
We compared the personality patterns of 103 patients (69.9% women) diagnosed with Lichen Simplex Chronicus, against a sample of healthy individuals.
RESULTS:
Significant differences were found in the personality styles of men and women with LSC. Women were more pessimistic, oriented to fulfil the needs of others, traditional, insecure, submissive, and reserved, with moderate (d=.43) to strong (d=.96) size effects ranges. Some of these differences, such as in traditionalism, dutifulness, other-orientation, and pessimism, were also observed when compared with healthy men and women, with small (d=.03) to moderate (d=.47) size effects ranges.
CONCLUSIONS:
These psychological factors may help explain the mechanisms underlying gender differences in chronic scratching, at least in Lichen Simplex Chronicus. The findings might open new avenues for research and treatment.
===========================================================
3.) Personality differences between patients with lichen simplex chronicus and normal population: A study of pruritus.
============================================================
Eur J Dermatol. 2010 May-Jun;20(3):359-63. doi: 10.1684/ejd.2010.0961. Epub 2010 Apr 13.
Martín-Brufau R1, Corbalán-Berná J, Ramirez-Andreo A, Brufau-Redondo C, Limiñana-Gras R.
Author information
1
Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Murcia, Av. Juan Carlos I, 6, 7 degrees H, 30008, Murcia, Spain. ramonmail@gmail.com
Abstract
Itching is common to many skin disorders. The relationship between skin disease and psychological variables has been widely documented in the literature. The association between the exacerbation of skin lesions and increased levels of psychopathological conditions in response to stressful events has also been described. Lichen Simplex Chronicus (LSC) is a skin disorder characterized by itching, which seems to have a marked psychological component. However, examples of empirical evidence linking this skin disorder to personality variables, as measured by standardized personality questionnaires, are relatively few so far. The objective of this research was to investigate the involvement of certain personality variables in the development of LSC. The personality profiles of 60 patients with LSC were compared to a normative sample of the normal Spanish population, who were free of any kind of skin disease. The personality variables for the LSC group were obtained by administering the Millon Index of Personality Styles (MIPS). Participants with LSC presented personality characteristics that differed from the control group. The most significant variables were as follows: greater tendency to pain-avoidance, greater dependency on other peoples' desires, and more conforming and dutiful compared to the control group. Results are discussed in the light of other dermatological pathologies that might share some characteristics with LSC subjects. Lichen simplex chronicus patients may present differential personality characteristics that could be related to triggering and exacerbating skin lesions. Therefore, it is relevant to evaluate the personality profiles of these people to increase treatment efficiency.
===========================================================
4.) Sleep disturbance in patients with lichen simplex chronicus and its relationship to nocturnal scratching: A case control study.
===========================================================
South Med J. 2006 May;99(5):482-5.
Koca R1, Altin R, Konuk N, Altinyazar HC, Kart L.
Author information
1
Department of Dermatology, Pulmonology, and Psychiatry, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak, Turkey. rafetkoca@karaelmas.edu.tr
Abstract
BACKGROUND:
Lichen simplex chronicus (LSC) is a common pruritic disorder resulting from repeated rubbing and scratching. Nighttime pruritus is a common feature in LSC and may disrupt the sleep pattern. The aim of this study is to determine whether there are sleep abnormalities in patients with LSC.
PATIENTS AND METHODS:
Fifteen patients with LSC and 15 age-, sex- and body mass index-matched control subjects were enrolled in the study. No participant had any other medical or psychiatric illness. All subjects were evaluated by overnight polysomnography, scratch electrodes, Epworth sleepiness scale and a general questionnaire for demographic data and sleep problems.
RESULTS:
There were no significant differences in the groups for total sleep time, sleep efficiency, sleep latency, rapid eye movement (REM) latency, percentage of stage 1 non-REM sleep and REM sleep. The percentage of stage 2 non-REM sleep was higher (P < 0.05) and the percentage of slow wave sleep (stages 3 and 4) was lower in the study group (P < 0.05) than in the controls. The patient group had a mean of 15.9 +/- 7.5 arousal index and 22.8 +/- 14.1 awakenings compared with 9.5 +/- 3.1 and 10.4 +/- 3.9, respectively, in the controls (P < 0.05, P < 0.01, respectively). Arousals of patients were mainly observed in non-REM sleep. The number of scratching bouts ranged from 6 to 20 per night. Scratching episodes were observed frequently during stage 2 non-REM sleep.
CONCLUSION:
Polysomnographic findings of patients with LSC demonstrated that sleep structure is disturbed by arousals and awakenings related to scratching bouts during sleep.
===========================================================
5.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
==========================================================
Dermatol Ther. 2004;17(1):8-19.
Lynch PJ1.
Author information
1
Department of Dermatology, University of California, Davis, California, USA. pjlynch@ucdavis.edu
Abstract
Lichen simplex chronicus (LSC) of the anogenital area is an eczematous disease characterized by unremitting itching and scratching. In most instances, it arises in individuals who are genetically atopic, and as such, LSC can be viewed as a localized variant of atopic/neurodermatitis. Common triggers for the development of the disease include psychological distress, and local environmental problems such as heat, sweating, and excess dryness. Lichen simplex chronicus may also develop as a superimposed condition in the presence of other anogenital diseases such as candidiasis, psoriasis, lichen sclerosus, tinea cruris, and neoplasia. Lichen simplex chronicus frequently persists as an itch-scratch cycle, even when environmental triggers are removed and the underlying disease is treated. For this reason, successful therapy requires attention not only to trigger factors, but also to repair of the damaged barrier layer, reduction in inflammation, and breakup of the itch-scratch cycle.
===========================================================
6.) Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort study.
===========================================================
Br J Dermatol. 2014 Apr;170(4):890-4. doi: 10.1111/bjd.12811.
Liao YH1, Lin CC, Tsai PP, Shen WC, Sung FC, Kao CH.
Author information
1
Department of Radiology, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404, Taiwan.
Abstract
BACKGROUND:
The cingulate cortex is the main area in the brain involved in pruritus processing and is deactivated after scratching. Lichen simplex chronicus (LSC) is a common pruritic skin disorder characterized by skin lichenification following excessive scratching. Psychological factors may contribute to both the development and persistence of LSC.
OBJECTIVES:
To estimate the hazard ratio (HR) of LSC in people with anxiety disorders compared with the general population.
METHODS:
In this nationwide population-based retrospective cohort study we identified a total of 69 386 people, who formed the anxiety cohort, by using the Taiwan National Health Insurance Research Database from 2000 to 2009. The comparison cohort was composed of randomly selected people frequency matched for age (within 5-year intervals), sex and index date (the date of anxiety diagnosis) based on a 1 : 2 ratio. The risk of LSC was estimated as HRs and 95% confidence intervals (CIs) using the Cox proportional hazards model.
RESULTS:
After adjusting for age, sex and LSC-associated comorbidities, the people with anxiety had a 1·41-fold greater risk of developing LSC compared with the people in the comparison cohort (HR 1·41, 95% CI 1·30-1·52, P < 0·0001). In particular, individuals with obsessive-compulsive disorder had a significantly increased risk of developing LSC (HR 1·72, 95% CI 1·03-2·88, P = 0·0395).
CONCLUSIONS:
This study demonstrates that having an anxiety disorder is associated with an increased risk of LSC. Psychological factors were found to contribute to LSC. We recommend combining the management of LSC and psychological disorders to achieve favourable outcomes.
===========================================================
7.) Emotions and skin (II)-the conditioning of scratch responses in cases of lichen simplex.
===========================================================
Br J Dermatol. 1975 Apr;92(4):407-12.
Roberston IM, Jordan JM, Whitlock FA.
Abstract
Lichen simplex is generally regarded as a condition initiated and perpetuated by scratching and emotional tension. It was felt that the scratching might partly be a conditional response to itching and other signals, and that feelings of guilt, anxiety and hostility would be prominent features in these patients. Conditioning experiments designed to establish scratch responses to an itch stimulus (UCS) and a tone (CS) showed that lichen simplex patients conditioned more readily and extinguished more slowly than controls. These finding were more marked when the itch stimulus was applied to affected as compared with normal skin. It was not possible to distinguish differences in the psychological tests between patients and controls. The possible significance of these findings is discussed.
===========================================================
8.) Lichen simplex chronicus - A Psychocutaneous disorder?
==========================================================
Indian J Dermatol Venereol Leprol. 1995 Nov-Dec;61(6):336-8.
Sanjana VD1, Fernandez RJ.
Author information
1
Department of Dermatology and Venereology, KEM Hospital, Parel, Mumbai-400012, India.
Abstract
Lichen simplex chronicus is classified as a skin disorder determined or influenced by emotional factors. This study was conducted to determine the involvement of the psyche in this psychocutaneous disorder. Forty six patients of lichen simplex chronicus were chosen for this study. The severity of pruritus was rated on a 10 point scale. They then underwent a psychiatric interview using the Hamilton anxiety-depression scale to quantitate their mental state. The numerical values of anxiety and depression did not exceed 50% of the measuring scale. This could be due to the 'venting' or exteriorisation of the inner turmoil, in this case by itching. The correlation between anxiety and pruritus and that of depression and pruritus was studied and it was surmised that depression may be related to pruritus compared to anxiety.
===========================================================
9.) Lichen simplex chronicus as a symptom of neuropathy.
===========================================================
Clin Exp Dermatol. 2009 Jun;34(4):476-80. doi: 10.1111/j.1365-2230.2008.02969.x. Epub 2008 Nov 27.
Solak O1, Kulac M, Yaman M, Karaca S, Toktas H, Kirpiko O, Kavuncu V.
Author information
1
Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University, School of Medicine, Afyon, Turkey. ozlemsolak@hotmail.com
Abstract
BACKGROUND:
The main cause of lichen simplex chronicus (LSC) is not known but there is evidence to suggest that neurological abnormalities may be implicated in its aetiology.
AIM:
To investigate neuropathy in patients with LSC on the limbs.
METHODS:
In total, 23 consecutive patients [15 women (65.2%) and 8 men (34.8%); mean +/- SD age 48.2 +/- 14.03 years, range 20-71] with LSC on the limbs were included in the study. Mean +/- SD duration of disease was 22.86 +/- 21.38 months (range 1-60). Radiography, magnetic resonance imaging (MRI) and electrophysiological studies were performed for all patients.
RESULTS:
In total, 8 patients (34.8%) had LSC on the arms and 15 patients (65.2%) had LSC on the legs; 3 (37.5%) of the 8 patients with LSC on the arms and 6 (40%) of the 15 patients with LSC on the legs had radiculopathy in the electrophysiological studies. The prevalence of radiculopathy in patients with LSC on the limbs was higher than in asymptomatic subjects in the electrophysiological studies.
CONCLUSIONS:
Damage to the peripheral nervous system, such as radiculopathy and neuropathy, can play a critical role in the aetiology of LSC on the limbs. Both nerve-root compression in MRI scans and radiculopathy in nerve-conduction studies are common findings in asymptomatic subjects, but they seem to be more common in patients with LSC on the limbs. Therefore, these patients should be evaluated for the possibility of underlying neuropathy.
===========================================================
10.) Clinical, epidemiological and therapeutic profile of patients with brachioradial pruritus in a reference service in dermatology.
===========================================================
An Bras Dermatol. 2016 Jul-Aug;91(4):549-51. doi: 10.1590/abd1806-4841.201644767.
Pinto AC1, Wachholz PA2, Masuda PY1, Martelli AC1.
Author information
1
Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
2
Universidade Estadual Paulista "Júlio de Mesquita Filho" (Unesp) - Botucatu (SP), Brazil.
Abstract
This is a cross-sectional study, conducted from May to November/2014, in a dermatology reference unit, through review of medical records and interviews. In a sample of 49 patients with brachioradial pruritus, we observed higher prevalence of Caucasian (81.6%) and women (73.5 %), with a mean age of 56.1 years. Pruritus occurred in the topography of brachioradialis muscle in 87.8% of cases; 59.2% of the sample reported worsening of pruritus with sun exposure; the mean intensity of this symptom before treatment was 8.63. Therapy effectiveness was described as "very good/good" in 79.2% of cases, and for 55.3% relapses were categorized as "uncommon".
===========================================================
11.) Study of pruritus vulvae in geriatric age group in tertiary hospital.
==========================================================
Indian J Sex Transm Dis. 2017 Jan-Jun;38(1):15-21. doi: 10.4103/0253-7184.192632.
Kaur J1, Kalsy J2.
Author information
1
Department of Dermatology, Venereology, Leprosy, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.
2
Department of Dermatology, Venereology, Leprosy, Government Medical College, Amritsar, Punjab, India.
Abstract
BACKGROUND:
According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.
METHODS:
We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.
RESULTS:
Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.
CONCLUSION:
Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.
===========================================================
12.) Lichenoid vulvar disease: A review.
===========================================================
Int J Womens Dermatol. 2017 Mar 27;3(1):58-64. doi: 10.1016/j.ijwd.2017.02.017. eCollection 2017 Mar.
Fruchter R1, Melnick L1, Pomeranz MK1,2.
Author information
1
The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY.
2
Department of Dermatology, NYC Health and Hospital/Bellevue, New York, NY.
Abstract
Vulvar dermatoses are common, potentially debilitating conditions that can be seen by a variety of medical specialists. Lichenoid vulvar diseases, namely lichen sclerosus (LS), lichen planus (LP), and lichen simplex chronicus (LSC), can all negatively impact patients' quality of life and LS and LP also have an association with squamous cell carcinoma. It is essential that dermatologists are familiar with the unique features of each of these conditions to ensure the appropriate management and follow up. Herein, we provide an update on the epidemiology, clinical presentation, histopathology, and treatment of patients with vulvar LS, LP, and LSC.
===========================================================
13.) Lichen simplex chronicus of the eyelid.
===========================================================
Arch Ophthalmol. 1999 Jun;117(6):829-31.
Ferry AP1, Kaltreider SA.
Author information
1
Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, USA.
Abstract
Lichen simplex chronicus is a common dermatosis that rarely affects the eyelids. We report the clinical and pathologic features in the case of a middle-aged man who had lichen simplex chronicus of both lower eyelids. The clinical features suggested the presence of basal cell carcinoma.
===========================================================
14.) Lichen amyloidosus: a consequence of scratching.
===========================================================
Weyers W1, Weyers I, Bonczkowitz M, Diaz-Cascajo C, Schill WB.
Author information
1
Center for Dermatopathology, Freiburg, Germany.
Abstract
BACKGROUND:
Lichen amyloidosus (LA) is generally said to be a pruritic type of amyloidosis of unknown cause. Histopathologically, it is characterized by epidermal changes of lichen simplex chronicus and by deposits of amyloid in the papillary dermis that are derived from keratin peptides of necrotic keratinocytes. Chronic scratching is responsible for the development of lichen simplex chronicus and may lead to necrosis of individual keratinocytes.
OBJECTIVE:
Our purpose was to evaluate whether chronic scratching may also be responsible for the formation of amyloid in LA.
METHODS:
We studied patients with LA in regard to histopathologic findings, onset of pruritus, associated diseases, and response to treatment.
RESULTS:
In most cases, pruritus had preceded the skin lesions. Eight of nine patients suffered from diseases other than LA that may be associated with pruritus. Histopathologically, amyloid was confined to areas that also showed signs of lichen simplex chronicus. Systemic treatment with sedating antihistamines and intense local treatment with corticosteroids were found to be effective.
CONCLUSION:
LA is considered to be a variant of lichen simplex chronicus in which scratching leads to necrosis of keratinocytes and eventually to the formation of amyloid in the papillary dermis. Because chronic scratching seems to be the cause and not the result of the deposits of amyloid, treatment should be directed at the amelioration of pruritus.
===========================================================
15.) Managing vulvar lichen simplex chronicus.
===========================================================
J Reprod Med. 2001 Apr;46(4):343-6.
Virgili A1, Bacilieri S, Corazza M.
Author information
1
Dermatology Section, Department of Clinical and Experimental Medicine, University of Ferrara, Via Savonarola 9, 44100 Ferrara, Italy.
Abstract
OBJECTIVE:
To develop a flow chart indicting which tests to perform with the aim of helping physicians with the diagnosis, management and treatment of lichen simplex chronicus.
STUDY DESIGN:
We reviewed the data on vulvar lichen simplex chronicus patients to delineate proper management.
RESULTS:
Patch test should be added to the series of tests performed to ascertain the causes of vulvar lichen simplex chronicus.
CONCLUSION:
Among the stimuli that may trigger vulvar lichen simplex chronicus, not only infections and irritating factors but also sensitization must be kept in mind, especially in long-lasting disease.
===========================================================
16.) Prurigo nodularis and lichen simplex chronicus.
===========================================================
Dermatol Ther. 2008 Jan-Feb;21(1):42-6. doi: 10.1111/j.1529-8019.2008.00168.x.
Lotti T1, Buggiani G, Prignano F.
Author information
1
Department of Dermatological Sciences, University of Florence, Florence, Italy. tlotti@unifi.it
Abstract
Emotional tensions in predisposed subjects may play a key role in inducing a pruritic sensation, leading to a scratching that, becoming a self-perpetuating pathomechanism, may represent the main feature of two distinct cutaneous clinical entities: prurigo nodularis and lichen simplex chronicus. Psychogenic factors play a relevant role in both conditions, and they are often associated with depression and dissociative experiences. Hence, the importance of the evaluation of these patients from the point of view of psychodermatology, which may analyze the relationship between skin disease and psychological factors. Patients with real or perceived imperfections in particular areas of the body (face, scalp, hands, and genital area) are more prone to psychologic distress, whereas cutaneous diseases may lead to experience a heightened level of distress. As psychosomatic factors have been estimated to be present in at least one-third of dermatologic patients, effective management of skin conditions involves consideration of the associated emotional factors.
============================================================
17.) [Lichen amyloidosus--disease entity or the effect of scratching].
============================================================
Hautarzt. 1995 Mar;46(3):165-72.
[Article in German]
Weyers W1.
Author information
1
Zentrum für Dermatologie und Andrologie, Justus-Liebig-Universität, Giessen.
Abstract
In current textbooks of dermatology, lichen amyloidosus is said to be a papular, intensely pruritic type of amyloidosis of unknown aetiology. When this concept was developed, there was no way of discriminating between the different types of amyloid. It is now known that amyloid in lichen amyloidosus is not derived from immunoglobulins or serum proteins, as it is in systemic amyloidoses, but from keratin peptides of necrotic keratinocytes. Even several years ago, chronic scratching was invoked as a possible cause of damage to keratinocytes in lichen amyloidosus. In support of this hypothesis, four cases are presented. Apart from amyloid in the papillary layer, all biopsy specimens revealed histopathological signs of chronic scratching (epithelial hyperplasia with hypergranulosis and compact orthokeratosis, coarse collagen in vertical streaks in the stratum papillare), such as are also found in prurigo nodularis and lichen simplex chronicus. Lichen amyloidosus is considered to be a variant of these conditions. Just as in prurigo nodularis and lichen simplex chronicus, pruritus seems to be the cause and not a symptom of the papular skin lesions. Consequently, treatment of lichen amyloidosus should not be directed at removing amyloid, but at improving the pruritus.
============================================================
18.) Clinical Study of 124 Patients Having Perianal Dermatitis.
============================================================
Dermatitis. 2017 Mar 23. doi: 10.1097/DER.0000000000000274. [Epub ahead of print]
Agulló-Pérez AD1, Hervella-Garcés M, Oscoz-Jaime S, Azcona-Rodríguez M, Larrea-García M, Yanguas-Bayona JI.
Author information
1
From the Department of Dermatology, Complejo Hospitalario de Navarra, Pamplona, Spain.
Abstract
BACKGROUND:
Perianal complaints are often consulted in dermatology clinics, and in many cases, a conclusive diagnosis is not easily made.
OBJECTIVE:
The aim of this study was to study and identify the epidemiological, clinical, and contact allergy features of patients with perianal dermatitis who attended at a contact dermatitis unit in a tertiary hospital in Spain.
METHODS:
Adult patients with long-lasting (>4 weeks) perianal dermatitis were recruited during the past 10 years for investigation and follow-up. Every patient underwent a diagnostic workup consisting of dermatological exploration and patch tests with the standard and specific series, as well as the patients' own products. General surgical exploration was also performed in some patients.
RESULTS:
One hundred twenty-four patients were included. The MOAHLFA index was as follows: 43.5, 0, 4.8, 11.3, 1.6, 8.1, and 75. The main final diagnoses were allergic contact dermatitis (32.3%), psoriasis (24.2%), irritant contact dermatitis (17.7%), and lichen simplex (neurodermatitis) (10%). Eighty-one patients (66.1%) showed 1 or more positive reactions, and in 52 patients (43%), positive reactions relevant to the present disease were found.
CONCLUSIONS:
Contact allergy in patients with long-lasting perianal complaints is frequent. It is mandatory for these patients to be referred to a dermatologist for an adequate evaluation and patch testing. Methylchloroisothiazolinone/methylisothiazolinone seems as the most common allergen implicated in perianal contact dermatitis.
============================================================
19.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
============================================================
Dermatol Ther. 2004;17(1):8-19.
Lynch PJ1.
Author information
1
Department of Dermatology, University of California, Davis, California, USA. pjlynch@ucdavis.edu
Abstract
Lichen simplex chronicus (LSC) of the anogenital area is an eczematous disease characterized by unremitting itching and scratching. In most instances, it arises in individuals who are genetically atopic, and as such, LSC can be viewed as a localized variant of atopic/neurodermatitis. Common triggers for the development of the disease include psychological distress, and local environmental problems such as heat, sweating, and excess dryness. Lichen simplex chronicus may also develop as a superimposed condition in the presence of other anogenital diseases such as candidiasis, psoriasis, lichen sclerosus, tinea cruris, and neoplasia. Lichen simplex chronicus frequently persists as an itch-scratch cycle, even when environmental triggers are removed and the underlying disease is treated. For this reason, successful therapy requires attention not only to trigger factors, but also to repair of the damaged barrier layer, reduction in inflammation, and breakup of the itch-scratch cycle.
============================================================
20.) Antidepressants have Anti-inflammatory Effects that may be Relevant to Dermatology: A Systematic Review.
============================================================
Acta Derm Venereol. 2017 May 17. doi: 10.2340/00015555-2702. [Epub ahead of print]
Eskeland S1, Halvorsen JA, Tanum L.
Author information
1
Department of Psychiatry, Oslo University Hospital, NO-0196 Oslo, Norway. shirolin@hotmail.com, shiesk@ous-hf.no.
Abstract
There is increasing evidence of clinically relevant anti-inflammatory effects of monoaminergic antidepressants. PubMed and Ovid databases were searched systematically for the use and efficacy of antidepressants in association with 5 common inflammatory skin disorders: chronic urticaria, psoriasis, atopic dermatitis, other eczema, and alopecia areata. From January 1984 to June 2016, publications included a total of 1,252 dermatological patients in 28 trials or case reports. These unambiguously reported a reduced burden of dermatological symptoms in relation to treatment with antidepressants. Several randomized controlled trials of first-generation antidepressants have been published, while studies of modern antidepressants are usually open-label, yet more informative, regarding patients' characteristics and study procedures. These overall positive findings may indicate a rationale, beyond treating comorbid psychiatric disorders, for the use of antidepressants in dermatology. Further research into modern tolerable antidepressants, including selective serotonin re-uptake inhibitors, mirtazapine and bupropion, is required.
============================================================
21.) [Risk hidden in the small print? : Some food additives may trigger pseudoallergic reactions].
============================================================
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Jun;59(6):777-82. doi: 10.1007/s00103-016-2347-2.
[Article in German]
Zuberbier T1, Hengstenberg C2.
Author information
1
Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. torsten.zuberbier@charite.de.
2
Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
Abstract
Some food additives may trigger pseudoallergenic reactions. However, the prevalence of such an overreaction is - despite the increasing number of food additives - rather low in the general population. The most common triggers of pseudoallergic reactions to food are naturally occurring ingredients. However, symptoms in patients with chronic urticaria should improve significantly on a pseudoallergen-free diet. In addition, some studies indicate that certain food additives may also have an impact on the symptoms of patients with neurodermatitis and asthma.
============================================================
22.) [Introduction neurodermatitis and urea].
============================================================
Hautarzt. 1992;43 Suppl 11:1-4.
[Article in German]
Wohlrab W1.
Author information
1
Universitäts-Hautklinik, Halle.
Abstract
Neurodermatitis is a multiphasic disease, yet despite intensive research, its etiopathogenesis still remains unclear. A large number of immunological and nonimmunological dysfunctions as well as their diverse interplay lead to very different types of manifestation. Consequently, treatment must also be varied and is mainly determined by the clinical picture. External therapy without glucocorticoids is no longer conceivable in acute and subacute dermatological conditions, although attenuated glucocorticoids which have the least amount of side effects should always be used. Improvement in the therapeutic efficacy of hydrocortisone can be achieved by combining it with urea which, depending on the vehicle used, represents one of the most effective penetration promoters for this glucocorticoid. Fighting the symptoms of dry skin and itching are of central importance in the follow-up treatment and prophylaxis of neurodermatitis. Here, urea preparations have been applied with great success. Urea's efficacy in the skin is largely based on its ability to elevate the water-binding capacity of the corneal layer, on its keratoplastic properties, its antipruriginous effect and its proliferation-suppressant action. However, the intensity and the duration of this therapeutic efficacy are dependent on several factors which must be taken into consideration in the galenics of urea preparations. As a whole, there is a multitude of possibilities for the use of urea in the therapy, follow-up and prophylaxis of neurodermatitis which we have only just begun to exploit in full.
============================================================
2.) [The use of H-1 antihistamine preparations in neurodermatitis patients].
============================================================
Vestn Dermatol Venerol. 1990;(11):31-4.
[Article in Russian]
Lezvinskaia EM, Sharpan' IuV, Kriazheva SS.
Abstract
Correlations between clinical variants of neurodermatitis course and patients' lymphocyte sensitivity to histamine are analyzed. The atopic form is associated with high lymphocyte sensitivity to histamine. Administration of H-1 antihistaminic agents to these patients is not always justified. Antihistaminic drugs should be prescribed to neurodermatitis patients with due consideration for the individual sensitivity of patient's lymphocytes to histamine.
============================================================
24.) Acupuncture as a Treatment Modality in Dermatology: A Systematic Review.
===========================================================
J Altern Complement Med. 2015 Sep;21(9):520-9. doi: 10.1089/acm.2014.0274. Epub 2015 Jun 26.
Ma C1, Sivamani RK1.
Author information
1
Department of Dermatology, University of California, Davis , Sacramento, CA.
Abstract
OBJECTIVES:
Acupuncture is a form of Traditional Chinese Medicine that has been used to treat a broad range of medical conditions, including dermatologic disorders. This systematic review aims to synthesize the evidence on the use of acupuncture as a primary treatment modality for dermatologic conditions.
METHODS:
A systematic search of MEDLINE, EMBASE, and the Cochrane Central Register was performed. Studies were limited to clinical trials, controlled studies, case reports, comparative studies, and systematic reviews published in the English language. Studies involving moxibustion, electroacupuncture, or blood-letting were excluded.
RESULTS:
Twenty-four studies met inclusion criteria. Among these, 16 were randomized controlled trials, 6 were prospective observational studies, and 2 were case reports. Acupuncture was used to treat atopic dermatitis, urticaria, pruritus, acne, chloasma, neurodermatitis, dermatitis herpetiformis, hyperhidrosis, human papillomavirus wart, breast inflammation, and facial elasticity. In 17 of 24 studies, acupuncture showed statistically significant improvements in outcome measurements compared with placebo acupuncture, alternative treatment options, and no intervention.
CONCLUSIONS:
Acupuncture improves outcome measures in the treatment of dermatitis, chloasma, pruritus, urticaria, hyperhidrosis, and facial elasticity. Future studies should ideally be double-blinded and standardize the control intervention.
============================================================
25.) Use of transcutaneous electrical nerve stimulation for chronic pruritus.
============================================================
Dermatol Ther. 2015 Jul-Aug;28(4):210-5. doi: 10.1111/dth.12242. Epub 2015 May 14.
Mohammad Ali BM1, Hegab DS1, El Saadany HM2.
Author information
1
Dermatology and Venereology Department, Faculty of Medicine, Tanta University.
2
Physical Medicine, Rheumatology & Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Abstract
Pruritus is a distressing symptom in many dermatological as well as systemic conditions, and it is sometimes very chronic and relapsing. Transcutaneous electrical nerve stimulation (TENS) is an inexpensive form of analgesia that could also ameliorate itching. This study aimed to evaluate TENS efficacy in patients with pruritus due to some types of chronic eczema, and in patients with chronic hepatic disease. Ten patients with atopic dermatitis (AD), 20 patients with lichen simplex chronicus (LSC), and 16 patients with chronic liver disease having chronic distressing pruritus received three sessions of TENS weekly for 12 sessions, and the effect on the visual analogue scale (VAS) scores was recorded after 2 weeks of therapy, at treatment end, and after an additional month for follow up. There was a statistically significant decline in the mean VAS score for studied groups at weeks 2 and 4 of therapy compared to baseline, but the improvement was more significant in patients with AD, and LSC (p < 0.001 for both) than in those with chronic liver disease (p < 0.01) who also showed an early re-elevation of VAS score on follow up. TENS therapy holds promise as a palliative, alternative, safe and inexpensive treatment for patients with some chronic pruritic conditions.
============================================================
26.) Dermatopathology in historical perspective: the Montgomery giant cell of lichen simplex chronicus.
===========================================================
Skinmed. 2010 Jan-Feb;8(1):54-5.
Rubakovic S1, Steffen C.
Author information
1
Internal Medicine, Rancho Mirage, CA, USA.
Abstract
In this short historical review, we will discuss the origin and references to the giant cell that is sometimes histopathologically present in the dermis of lichen simplex chronicus that was first described by Hamilton Montgomery, MD. A photomicrograph of the giant cell was included by Montgomery in his text Dermatopathology published in 1967. We will then provide a short biography of Montgomery.
===========================================================
27.) Perianal lichen dermatoses: A review of 60 cases.3.) Personality differences between patients with lichen simplex chronicus and normal population: A study of pruritus.
4.) Sleep disturbance in patients with lichen simplex chronicus and its relationship to nocturnal scratching: A case control study.
5.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
6.) Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort study.
7.) Emotions and skin (II)-the conditioning of scratch responses in cases of lichen simplex.
8.) Lichen simplex chronicus - A Psychocutaneous disorder?
9.) Lichen simplex chronicus as a symptom of neuropathy.
10.) Clinical, epidemiological and therapeutic profile of patients with brachioradial pruritus in a reference service in dermatology.
11.) Study of pruritus vulvae in geriatric age group in tertiary hospital.
12.) Lichenoid vulvar disease: A review.
13.) Lichen simplex chronicus of the eyelid.
14.) Lichen amyloidosus: a consequence of scratching.
15.) Managing vulvar lichen simplex chronicus.
16.) Prurigo nodularis and lichen simplex chronicus.
17.) [Lichen amyloidosus--disease entity or the effect of scratching].
18.) Clinical Study of 124 Patients Having Perianal Dermatitis.
19.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
20.) Antidepressants have Anti-inflammatory Effects that may be Relevant to Dermatology: A Systematic Review.
21.) [Risk hidden in the small print? : Some food additives may trigger pseudoallergic reactions].
22.) [Introduction neurodermatitis and urea].
23.) [The use of H-1 antihistamine preparations in neurodermatitis patients].
24.) Acupuncture as a Treatment Modality in Dermatology: A Systematic Review.
25.) Use of transcutaneous electrical nerve stimulation for chronic pruritus.
26.) Dermatopathology in historical perspective: the Montgomery giant cell of lichen simplex chronicus.
14.) Perianal lichen dermatoses: A review of 60 cases. =============================================================
===========================================================
1.) [Neurodermatitis : Atopy of the skin].
===========================================================
Ophthalmologe. 2017 Apr 26. doi: 10.1007/s00347-017-0495-x. [Epub ahead of print]
[Article in German]
Fölster-Holst R1.
Author information
1
Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 7, 24105, Kiel, Deutschland. rfoelsterholst@dermatology.uni-kiel.de.
Abstract
Atopic dermatitis is one of the most common skin diseases and is associated with an impaired quality of life due to tormenting itching and stigmatization. The disease almost always manifests in early childhood and exhibits specific features in this phase, with involvement of the extensor sides of the extremities. During the further course of disease, the typical flexor involvement becomes quite clear and a considerable proportion of patients develop the associated atopic respiratory diseases. Therapeutic and prophylactic measures focus on the prevention of trigger factors, basic skin care, and application of lipid-replenishing creams, as well as patient and parent education. In the case of exacerbation, anti-inflammatory drugs are treatment of choice.
===========================================================
2.) Differences Between Men and Women in Chronic Scratching: A Psychodermatologic Study in Lichen Simplex Chronicus.
===========================================================
Actas Dermosifiliogr. 2017 May;108(4):354-360. doi: 10.1016/j.ad.2016.12.002. Epub 2017 Feb 2.
[Article in English, Spanish]
Martín-Brufau R1, Suso-Ribera C2, Brufau Redondo C3, Corbalán Berná J4.
Author information
1
Faculty of Psychology, University of Murcia, Spain. Electronic address: ramonmail@gmail.com.
2
Faculty of Psychology, University of Barcelona, Spain.
3
Service of Dermatology, Hospital Reina Sofía, Murcia, Spain; Faculty of Medicine, University of Murcia, Spain.
4
Faculty of Psychology, University of Murcia, Spain.
Abstract
INTRODUCTION:
Chronic scratching is common to many skin disorders. Being a female and presenting a high level of psychopathology are risk factors for chronic scratching. Yet, it is unclear why. Certain personality characteristics that are more prevalent in women are also known to influence emotional states (i.e. emotional tension).
OBJECTIVE:
The present study aims to explore whether these personality styles might help understand why gender and emotional distress are associated with scratching.
MATERIAL AND METHODS:
We compared the personality patterns of 103 patients (69.9% women) diagnosed with Lichen Simplex Chronicus, against a sample of healthy individuals.
RESULTS:
Significant differences were found in the personality styles of men and women with LSC. Women were more pessimistic, oriented to fulfil the needs of others, traditional, insecure, submissive, and reserved, with moderate (d=.43) to strong (d=.96) size effects ranges. Some of these differences, such as in traditionalism, dutifulness, other-orientation, and pessimism, were also observed when compared with healthy men and women, with small (d=.03) to moderate (d=.47) size effects ranges.
CONCLUSIONS:
These psychological factors may help explain the mechanisms underlying gender differences in chronic scratching, at least in Lichen Simplex Chronicus. The findings might open new avenues for research and treatment.
===========================================================
3.) Personality differences between patients with lichen simplex chronicus and normal population: A study of pruritus.
============================================================
Eur J Dermatol. 2010 May-Jun;20(3):359-63. doi: 10.1684/ejd.2010.0961. Epub 2010 Apr 13.
Martín-Brufau R1, Corbalán-Berná J, Ramirez-Andreo A, Brufau-Redondo C, Limiñana-Gras R.
Author information
1
Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Murcia, Av. Juan Carlos I, 6, 7 degrees H, 30008, Murcia, Spain. ramonmail@gmail.com
Abstract
Itching is common to many skin disorders. The relationship between skin disease and psychological variables has been widely documented in the literature. The association between the exacerbation of skin lesions and increased levels of psychopathological conditions in response to stressful events has also been described. Lichen Simplex Chronicus (LSC) is a skin disorder characterized by itching, which seems to have a marked psychological component. However, examples of empirical evidence linking this skin disorder to personality variables, as measured by standardized personality questionnaires, are relatively few so far. The objective of this research was to investigate the involvement of certain personality variables in the development of LSC. The personality profiles of 60 patients with LSC were compared to a normative sample of the normal Spanish population, who were free of any kind of skin disease. The personality variables for the LSC group were obtained by administering the Millon Index of Personality Styles (MIPS). Participants with LSC presented personality characteristics that differed from the control group. The most significant variables were as follows: greater tendency to pain-avoidance, greater dependency on other peoples' desires, and more conforming and dutiful compared to the control group. Results are discussed in the light of other dermatological pathologies that might share some characteristics with LSC subjects. Lichen simplex chronicus patients may present differential personality characteristics that could be related to triggering and exacerbating skin lesions. Therefore, it is relevant to evaluate the personality profiles of these people to increase treatment efficiency.
===========================================================
4.) Sleep disturbance in patients with lichen simplex chronicus and its relationship to nocturnal scratching: A case control study.
===========================================================
South Med J. 2006 May;99(5):482-5.
Koca R1, Altin R, Konuk N, Altinyazar HC, Kart L.
Author information
1
Department of Dermatology, Pulmonology, and Psychiatry, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak, Turkey. rafetkoca@karaelmas.edu.tr
Abstract
BACKGROUND:
Lichen simplex chronicus (LSC) is a common pruritic disorder resulting from repeated rubbing and scratching. Nighttime pruritus is a common feature in LSC and may disrupt the sleep pattern. The aim of this study is to determine whether there are sleep abnormalities in patients with LSC.
PATIENTS AND METHODS:
Fifteen patients with LSC and 15 age-, sex- and body mass index-matched control subjects were enrolled in the study. No participant had any other medical or psychiatric illness. All subjects were evaluated by overnight polysomnography, scratch electrodes, Epworth sleepiness scale and a general questionnaire for demographic data and sleep problems.
RESULTS:
There were no significant differences in the groups for total sleep time, sleep efficiency, sleep latency, rapid eye movement (REM) latency, percentage of stage 1 non-REM sleep and REM sleep. The percentage of stage 2 non-REM sleep was higher (P < 0.05) and the percentage of slow wave sleep (stages 3 and 4) was lower in the study group (P < 0.05) than in the controls. The patient group had a mean of 15.9 +/- 7.5 arousal index and 22.8 +/- 14.1 awakenings compared with 9.5 +/- 3.1 and 10.4 +/- 3.9, respectively, in the controls (P < 0.05, P < 0.01, respectively). Arousals of patients were mainly observed in non-REM sleep. The number of scratching bouts ranged from 6 to 20 per night. Scratching episodes were observed frequently during stage 2 non-REM sleep.
CONCLUSION:
Polysomnographic findings of patients with LSC demonstrated that sleep structure is disturbed by arousals and awakenings related to scratching bouts during sleep.
===========================================================
5.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
==========================================================
Dermatol Ther. 2004;17(1):8-19.
Lynch PJ1.
Author information
1
Department of Dermatology, University of California, Davis, California, USA. pjlynch@ucdavis.edu
Abstract
Lichen simplex chronicus (LSC) of the anogenital area is an eczematous disease characterized by unremitting itching and scratching. In most instances, it arises in individuals who are genetically atopic, and as such, LSC can be viewed as a localized variant of atopic/neurodermatitis. Common triggers for the development of the disease include psychological distress, and local environmental problems such as heat, sweating, and excess dryness. Lichen simplex chronicus may also develop as a superimposed condition in the presence of other anogenital diseases such as candidiasis, psoriasis, lichen sclerosus, tinea cruris, and neoplasia. Lichen simplex chronicus frequently persists as an itch-scratch cycle, even when environmental triggers are removed and the underlying disease is treated. For this reason, successful therapy requires attention not only to trigger factors, but also to repair of the damaged barrier layer, reduction in inflammation, and breakup of the itch-scratch cycle.
===========================================================
6.) Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort study.
===========================================================
Br J Dermatol. 2014 Apr;170(4):890-4. doi: 10.1111/bjd.12811.
Liao YH1, Lin CC, Tsai PP, Shen WC, Sung FC, Kao CH.
Author information
1
Department of Radiology, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404, Taiwan.
Abstract
BACKGROUND:
The cingulate cortex is the main area in the brain involved in pruritus processing and is deactivated after scratching. Lichen simplex chronicus (LSC) is a common pruritic skin disorder characterized by skin lichenification following excessive scratching. Psychological factors may contribute to both the development and persistence of LSC.
OBJECTIVES:
To estimate the hazard ratio (HR) of LSC in people with anxiety disorders compared with the general population.
METHODS:
In this nationwide population-based retrospective cohort study we identified a total of 69 386 people, who formed the anxiety cohort, by using the Taiwan National Health Insurance Research Database from 2000 to 2009. The comparison cohort was composed of randomly selected people frequency matched for age (within 5-year intervals), sex and index date (the date of anxiety diagnosis) based on a 1 : 2 ratio. The risk of LSC was estimated as HRs and 95% confidence intervals (CIs) using the Cox proportional hazards model.
RESULTS:
After adjusting for age, sex and LSC-associated comorbidities, the people with anxiety had a 1·41-fold greater risk of developing LSC compared with the people in the comparison cohort (HR 1·41, 95% CI 1·30-1·52, P < 0·0001). In particular, individuals with obsessive-compulsive disorder had a significantly increased risk of developing LSC (HR 1·72, 95% CI 1·03-2·88, P = 0·0395).
CONCLUSIONS:
This study demonstrates that having an anxiety disorder is associated with an increased risk of LSC. Psychological factors were found to contribute to LSC. We recommend combining the management of LSC and psychological disorders to achieve favourable outcomes.
===========================================================
7.) Emotions and skin (II)-the conditioning of scratch responses in cases of lichen simplex.
===========================================================
Br J Dermatol. 1975 Apr;92(4):407-12.
Roberston IM, Jordan JM, Whitlock FA.
Abstract
Lichen simplex is generally regarded as a condition initiated and perpetuated by scratching and emotional tension. It was felt that the scratching might partly be a conditional response to itching and other signals, and that feelings of guilt, anxiety and hostility would be prominent features in these patients. Conditioning experiments designed to establish scratch responses to an itch stimulus (UCS) and a tone (CS) showed that lichen simplex patients conditioned more readily and extinguished more slowly than controls. These finding were more marked when the itch stimulus was applied to affected as compared with normal skin. It was not possible to distinguish differences in the psychological tests between patients and controls. The possible significance of these findings is discussed.
===========================================================
8.) Lichen simplex chronicus - A Psychocutaneous disorder?
==========================================================
Indian J Dermatol Venereol Leprol. 1995 Nov-Dec;61(6):336-8.
Sanjana VD1, Fernandez RJ.
Author information
1
Department of Dermatology and Venereology, KEM Hospital, Parel, Mumbai-400012, India.
Abstract
Lichen simplex chronicus is classified as a skin disorder determined or influenced by emotional factors. This study was conducted to determine the involvement of the psyche in this psychocutaneous disorder. Forty six patients of lichen simplex chronicus were chosen for this study. The severity of pruritus was rated on a 10 point scale. They then underwent a psychiatric interview using the Hamilton anxiety-depression scale to quantitate their mental state. The numerical values of anxiety and depression did not exceed 50% of the measuring scale. This could be due to the 'venting' or exteriorisation of the inner turmoil, in this case by itching. The correlation between anxiety and pruritus and that of depression and pruritus was studied and it was surmised that depression may be related to pruritus compared to anxiety.
===========================================================
9.) Lichen simplex chronicus as a symptom of neuropathy.
===========================================================
Clin Exp Dermatol. 2009 Jun;34(4):476-80. doi: 10.1111/j.1365-2230.2008.02969.x. Epub 2008 Nov 27.
Solak O1, Kulac M, Yaman M, Karaca S, Toktas H, Kirpiko O, Kavuncu V.
Author information
1
Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University, School of Medicine, Afyon, Turkey. ozlemsolak@hotmail.com
Abstract
BACKGROUND:
The main cause of lichen simplex chronicus (LSC) is not known but there is evidence to suggest that neurological abnormalities may be implicated in its aetiology.
AIM:
To investigate neuropathy in patients with LSC on the limbs.
METHODS:
In total, 23 consecutive patients [15 women (65.2%) and 8 men (34.8%); mean +/- SD age 48.2 +/- 14.03 years, range 20-71] with LSC on the limbs were included in the study. Mean +/- SD duration of disease was 22.86 +/- 21.38 months (range 1-60). Radiography, magnetic resonance imaging (MRI) and electrophysiological studies were performed for all patients.
RESULTS:
In total, 8 patients (34.8%) had LSC on the arms and 15 patients (65.2%) had LSC on the legs; 3 (37.5%) of the 8 patients with LSC on the arms and 6 (40%) of the 15 patients with LSC on the legs had radiculopathy in the electrophysiological studies. The prevalence of radiculopathy in patients with LSC on the limbs was higher than in asymptomatic subjects in the electrophysiological studies.
CONCLUSIONS:
Damage to the peripheral nervous system, such as radiculopathy and neuropathy, can play a critical role in the aetiology of LSC on the limbs. Both nerve-root compression in MRI scans and radiculopathy in nerve-conduction studies are common findings in asymptomatic subjects, but they seem to be more common in patients with LSC on the limbs. Therefore, these patients should be evaluated for the possibility of underlying neuropathy.
===========================================================
10.) Clinical, epidemiological and therapeutic profile of patients with brachioradial pruritus in a reference service in dermatology.
===========================================================
An Bras Dermatol. 2016 Jul-Aug;91(4):549-51. doi: 10.1590/abd1806-4841.201644767.
Pinto AC1, Wachholz PA2, Masuda PY1, Martelli AC1.
Author information
1
Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.
2
Universidade Estadual Paulista "Júlio de Mesquita Filho" (Unesp) - Botucatu (SP), Brazil.
Abstract
This is a cross-sectional study, conducted from May to November/2014, in a dermatology reference unit, through review of medical records and interviews. In a sample of 49 patients with brachioradial pruritus, we observed higher prevalence of Caucasian (81.6%) and women (73.5 %), with a mean age of 56.1 years. Pruritus occurred in the topography of brachioradialis muscle in 87.8% of cases; 59.2% of the sample reported worsening of pruritus with sun exposure; the mean intensity of this symptom before treatment was 8.63. Therapy effectiveness was described as "very good/good" in 79.2% of cases, and for 55.3% relapses were categorized as "uncommon".
===========================================================
11.) Study of pruritus vulvae in geriatric age group in tertiary hospital.
==========================================================
Indian J Sex Transm Dis. 2017 Jan-Jun;38(1):15-21. doi: 10.4103/0253-7184.192632.
Kaur J1, Kalsy J2.
Author information
1
Department of Dermatology, Venereology, Leprosy, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.
2
Department of Dermatology, Venereology, Leprosy, Government Medical College, Amritsar, Punjab, India.
Abstract
BACKGROUND:
According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.
METHODS:
We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.
RESULTS:
Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.
CONCLUSION:
Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.
===========================================================
12.) Lichenoid vulvar disease: A review.
===========================================================
Int J Womens Dermatol. 2017 Mar 27;3(1):58-64. doi: 10.1016/j.ijwd.2017.02.017. eCollection 2017 Mar.
Fruchter R1, Melnick L1, Pomeranz MK1,2.
Author information
1
The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY.
2
Department of Dermatology, NYC Health and Hospital/Bellevue, New York, NY.
Abstract
Vulvar dermatoses are common, potentially debilitating conditions that can be seen by a variety of medical specialists. Lichenoid vulvar diseases, namely lichen sclerosus (LS), lichen planus (LP), and lichen simplex chronicus (LSC), can all negatively impact patients' quality of life and LS and LP also have an association with squamous cell carcinoma. It is essential that dermatologists are familiar with the unique features of each of these conditions to ensure the appropriate management and follow up. Herein, we provide an update on the epidemiology, clinical presentation, histopathology, and treatment of patients with vulvar LS, LP, and LSC.
===========================================================
13.) Lichen simplex chronicus of the eyelid.
===========================================================
Arch Ophthalmol. 1999 Jun;117(6):829-31.
Ferry AP1, Kaltreider SA.
Author information
1
Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, USA.
Abstract
Lichen simplex chronicus is a common dermatosis that rarely affects the eyelids. We report the clinical and pathologic features in the case of a middle-aged man who had lichen simplex chronicus of both lower eyelids. The clinical features suggested the presence of basal cell carcinoma.
===========================================================
14.) Lichen amyloidosus: a consequence of scratching.
===========================================================
Weyers W1, Weyers I, Bonczkowitz M, Diaz-Cascajo C, Schill WB.
Author information
1
Center for Dermatopathology, Freiburg, Germany.
Abstract
BACKGROUND:
Lichen amyloidosus (LA) is generally said to be a pruritic type of amyloidosis of unknown cause. Histopathologically, it is characterized by epidermal changes of lichen simplex chronicus and by deposits of amyloid in the papillary dermis that are derived from keratin peptides of necrotic keratinocytes. Chronic scratching is responsible for the development of lichen simplex chronicus and may lead to necrosis of individual keratinocytes.
OBJECTIVE:
Our purpose was to evaluate whether chronic scratching may also be responsible for the formation of amyloid in LA.
METHODS:
We studied patients with LA in regard to histopathologic findings, onset of pruritus, associated diseases, and response to treatment.
RESULTS:
In most cases, pruritus had preceded the skin lesions. Eight of nine patients suffered from diseases other than LA that may be associated with pruritus. Histopathologically, amyloid was confined to areas that also showed signs of lichen simplex chronicus. Systemic treatment with sedating antihistamines and intense local treatment with corticosteroids were found to be effective.
CONCLUSION:
LA is considered to be a variant of lichen simplex chronicus in which scratching leads to necrosis of keratinocytes and eventually to the formation of amyloid in the papillary dermis. Because chronic scratching seems to be the cause and not the result of the deposits of amyloid, treatment should be directed at the amelioration of pruritus.
===========================================================
15.) Managing vulvar lichen simplex chronicus.
===========================================================
J Reprod Med. 2001 Apr;46(4):343-6.
Virgili A1, Bacilieri S, Corazza M.
Author information
1
Dermatology Section, Department of Clinical and Experimental Medicine, University of Ferrara, Via Savonarola 9, 44100 Ferrara, Italy.
Abstract
OBJECTIVE:
To develop a flow chart indicting which tests to perform with the aim of helping physicians with the diagnosis, management and treatment of lichen simplex chronicus.
STUDY DESIGN:
We reviewed the data on vulvar lichen simplex chronicus patients to delineate proper management.
RESULTS:
Patch test should be added to the series of tests performed to ascertain the causes of vulvar lichen simplex chronicus.
CONCLUSION:
Among the stimuli that may trigger vulvar lichen simplex chronicus, not only infections and irritating factors but also sensitization must be kept in mind, especially in long-lasting disease.
===========================================================
16.) Prurigo nodularis and lichen simplex chronicus.
===========================================================
Dermatol Ther. 2008 Jan-Feb;21(1):42-6. doi: 10.1111/j.1529-8019.2008.00168.x.
Lotti T1, Buggiani G, Prignano F.
Author information
1
Department of Dermatological Sciences, University of Florence, Florence, Italy. tlotti@unifi.it
Abstract
Emotional tensions in predisposed subjects may play a key role in inducing a pruritic sensation, leading to a scratching that, becoming a self-perpetuating pathomechanism, may represent the main feature of two distinct cutaneous clinical entities: prurigo nodularis and lichen simplex chronicus. Psychogenic factors play a relevant role in both conditions, and they are often associated with depression and dissociative experiences. Hence, the importance of the evaluation of these patients from the point of view of psychodermatology, which may analyze the relationship between skin disease and psychological factors. Patients with real or perceived imperfections in particular areas of the body (face, scalp, hands, and genital area) are more prone to psychologic distress, whereas cutaneous diseases may lead to experience a heightened level of distress. As psychosomatic factors have been estimated to be present in at least one-third of dermatologic patients, effective management of skin conditions involves consideration of the associated emotional factors.
============================================================
17.) [Lichen amyloidosus--disease entity or the effect of scratching].
============================================================
Hautarzt. 1995 Mar;46(3):165-72.
[Article in German]
Weyers W1.
Author information
1
Zentrum für Dermatologie und Andrologie, Justus-Liebig-Universität, Giessen.
Abstract
In current textbooks of dermatology, lichen amyloidosus is said to be a papular, intensely pruritic type of amyloidosis of unknown aetiology. When this concept was developed, there was no way of discriminating between the different types of amyloid. It is now known that amyloid in lichen amyloidosus is not derived from immunoglobulins or serum proteins, as it is in systemic amyloidoses, but from keratin peptides of necrotic keratinocytes. Even several years ago, chronic scratching was invoked as a possible cause of damage to keratinocytes in lichen amyloidosus. In support of this hypothesis, four cases are presented. Apart from amyloid in the papillary layer, all biopsy specimens revealed histopathological signs of chronic scratching (epithelial hyperplasia with hypergranulosis and compact orthokeratosis, coarse collagen in vertical streaks in the stratum papillare), such as are also found in prurigo nodularis and lichen simplex chronicus. Lichen amyloidosus is considered to be a variant of these conditions. Just as in prurigo nodularis and lichen simplex chronicus, pruritus seems to be the cause and not a symptom of the papular skin lesions. Consequently, treatment of lichen amyloidosus should not be directed at removing amyloid, but at improving the pruritus.
============================================================
18.) Clinical Study of 124 Patients Having Perianal Dermatitis.
============================================================
Dermatitis. 2017 Mar 23. doi: 10.1097/DER.0000000000000274. [Epub ahead of print]
Agulló-Pérez AD1, Hervella-Garcés M, Oscoz-Jaime S, Azcona-Rodríguez M, Larrea-García M, Yanguas-Bayona JI.
Author information
1
From the Department of Dermatology, Complejo Hospitalario de Navarra, Pamplona, Spain.
Abstract
BACKGROUND:
Perianal complaints are often consulted in dermatology clinics, and in many cases, a conclusive diagnosis is not easily made.
OBJECTIVE:
The aim of this study was to study and identify the epidemiological, clinical, and contact allergy features of patients with perianal dermatitis who attended at a contact dermatitis unit in a tertiary hospital in Spain.
METHODS:
Adult patients with long-lasting (>4 weeks) perianal dermatitis were recruited during the past 10 years for investigation and follow-up. Every patient underwent a diagnostic workup consisting of dermatological exploration and patch tests with the standard and specific series, as well as the patients' own products. General surgical exploration was also performed in some patients.
RESULTS:
One hundred twenty-four patients were included. The MOAHLFA index was as follows: 43.5, 0, 4.8, 11.3, 1.6, 8.1, and 75. The main final diagnoses were allergic contact dermatitis (32.3%), psoriasis (24.2%), irritant contact dermatitis (17.7%), and lichen simplex (neurodermatitis) (10%). Eighty-one patients (66.1%) showed 1 or more positive reactions, and in 52 patients (43%), positive reactions relevant to the present disease were found.
CONCLUSIONS:
Contact allergy in patients with long-lasting perianal complaints is frequent. It is mandatory for these patients to be referred to a dermatologist for an adequate evaluation and patch testing. Methylchloroisothiazolinone/methylisothiazolinone seems as the most common allergen implicated in perianal contact dermatitis.
============================================================
19.) Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region.
============================================================
Dermatol Ther. 2004;17(1):8-19.
Lynch PJ1.
Author information
1
Department of Dermatology, University of California, Davis, California, USA. pjlynch@ucdavis.edu
Abstract
Lichen simplex chronicus (LSC) of the anogenital area is an eczematous disease characterized by unremitting itching and scratching. In most instances, it arises in individuals who are genetically atopic, and as such, LSC can be viewed as a localized variant of atopic/neurodermatitis. Common triggers for the development of the disease include psychological distress, and local environmental problems such as heat, sweating, and excess dryness. Lichen simplex chronicus may also develop as a superimposed condition in the presence of other anogenital diseases such as candidiasis, psoriasis, lichen sclerosus, tinea cruris, and neoplasia. Lichen simplex chronicus frequently persists as an itch-scratch cycle, even when environmental triggers are removed and the underlying disease is treated. For this reason, successful therapy requires attention not only to trigger factors, but also to repair of the damaged barrier layer, reduction in inflammation, and breakup of the itch-scratch cycle.
============================================================
20.) Antidepressants have Anti-inflammatory Effects that may be Relevant to Dermatology: A Systematic Review.
============================================================
Acta Derm Venereol. 2017 May 17. doi: 10.2340/00015555-2702. [Epub ahead of print]
Eskeland S1, Halvorsen JA, Tanum L.
Author information
1
Department of Psychiatry, Oslo University Hospital, NO-0196 Oslo, Norway. shirolin@hotmail.com, shiesk@ous-hf.no.
Abstract
There is increasing evidence of clinically relevant anti-inflammatory effects of monoaminergic antidepressants. PubMed and Ovid databases were searched systematically for the use and efficacy of antidepressants in association with 5 common inflammatory skin disorders: chronic urticaria, psoriasis, atopic dermatitis, other eczema, and alopecia areata. From January 1984 to June 2016, publications included a total of 1,252 dermatological patients in 28 trials or case reports. These unambiguously reported a reduced burden of dermatological symptoms in relation to treatment with antidepressants. Several randomized controlled trials of first-generation antidepressants have been published, while studies of modern antidepressants are usually open-label, yet more informative, regarding patients' characteristics and study procedures. These overall positive findings may indicate a rationale, beyond treating comorbid psychiatric disorders, for the use of antidepressants in dermatology. Further research into modern tolerable antidepressants, including selective serotonin re-uptake inhibitors, mirtazapine and bupropion, is required.
============================================================
21.) [Risk hidden in the small print? : Some food additives may trigger pseudoallergic reactions].
============================================================
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Jun;59(6):777-82. doi: 10.1007/s00103-016-2347-2.
[Article in German]
Zuberbier T1, Hengstenberg C2.
Author information
1
Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. torsten.zuberbier@charite.de.
2
Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
Abstract
Some food additives may trigger pseudoallergenic reactions. However, the prevalence of such an overreaction is - despite the increasing number of food additives - rather low in the general population. The most common triggers of pseudoallergic reactions to food are naturally occurring ingredients. However, symptoms in patients with chronic urticaria should improve significantly on a pseudoallergen-free diet. In addition, some studies indicate that certain food additives may also have an impact on the symptoms of patients with neurodermatitis and asthma.
============================================================
22.) [Introduction neurodermatitis and urea].
============================================================
Hautarzt. 1992;43 Suppl 11:1-4.
[Article in German]
Wohlrab W1.
Author information
1
Universitäts-Hautklinik, Halle.
Abstract
Neurodermatitis is a multiphasic disease, yet despite intensive research, its etiopathogenesis still remains unclear. A large number of immunological and nonimmunological dysfunctions as well as their diverse interplay lead to very different types of manifestation. Consequently, treatment must also be varied and is mainly determined by the clinical picture. External therapy without glucocorticoids is no longer conceivable in acute and subacute dermatological conditions, although attenuated glucocorticoids which have the least amount of side effects should always be used. Improvement in the therapeutic efficacy of hydrocortisone can be achieved by combining it with urea which, depending on the vehicle used, represents one of the most effective penetration promoters for this glucocorticoid. Fighting the symptoms of dry skin and itching are of central importance in the follow-up treatment and prophylaxis of neurodermatitis. Here, urea preparations have been applied with great success. Urea's efficacy in the skin is largely based on its ability to elevate the water-binding capacity of the corneal layer, on its keratoplastic properties, its antipruriginous effect and its proliferation-suppressant action. However, the intensity and the duration of this therapeutic efficacy are dependent on several factors which must be taken into consideration in the galenics of urea preparations. As a whole, there is a multitude of possibilities for the use of urea in the therapy, follow-up and prophylaxis of neurodermatitis which we have only just begun to exploit in full.
============================================================
2.) [The use of H-1 antihistamine preparations in neurodermatitis patients].
============================================================
Vestn Dermatol Venerol. 1990;(11):31-4.
[Article in Russian]
Lezvinskaia EM, Sharpan' IuV, Kriazheva SS.
Abstract
Correlations between clinical variants of neurodermatitis course and patients' lymphocyte sensitivity to histamine are analyzed. The atopic form is associated with high lymphocyte sensitivity to histamine. Administration of H-1 antihistaminic agents to these patients is not always justified. Antihistaminic drugs should be prescribed to neurodermatitis patients with due consideration for the individual sensitivity of patient's lymphocytes to histamine.
============================================================
24.) Acupuncture as a Treatment Modality in Dermatology: A Systematic Review.
===========================================================
J Altern Complement Med. 2015 Sep;21(9):520-9. doi: 10.1089/acm.2014.0274. Epub 2015 Jun 26.
Ma C1, Sivamani RK1.
Author information
1
Department of Dermatology, University of California, Davis , Sacramento, CA.
Abstract
OBJECTIVES:
Acupuncture is a form of Traditional Chinese Medicine that has been used to treat a broad range of medical conditions, including dermatologic disorders. This systematic review aims to synthesize the evidence on the use of acupuncture as a primary treatment modality for dermatologic conditions.
METHODS:
A systematic search of MEDLINE, EMBASE, and the Cochrane Central Register was performed. Studies were limited to clinical trials, controlled studies, case reports, comparative studies, and systematic reviews published in the English language. Studies involving moxibustion, electroacupuncture, or blood-letting were excluded.
RESULTS:
Twenty-four studies met inclusion criteria. Among these, 16 were randomized controlled trials, 6 were prospective observational studies, and 2 were case reports. Acupuncture was used to treat atopic dermatitis, urticaria, pruritus, acne, chloasma, neurodermatitis, dermatitis herpetiformis, hyperhidrosis, human papillomavirus wart, breast inflammation, and facial elasticity. In 17 of 24 studies, acupuncture showed statistically significant improvements in outcome measurements compared with placebo acupuncture, alternative treatment options, and no intervention.
CONCLUSIONS:
Acupuncture improves outcome measures in the treatment of dermatitis, chloasma, pruritus, urticaria, hyperhidrosis, and facial elasticity. Future studies should ideally be double-blinded and standardize the control intervention.
============================================================
25.) Use of transcutaneous electrical nerve stimulation for chronic pruritus.
============================================================
Dermatol Ther. 2015 Jul-Aug;28(4):210-5. doi: 10.1111/dth.12242. Epub 2015 May 14.
Mohammad Ali BM1, Hegab DS1, El Saadany HM2.
Author information
1
Dermatology and Venereology Department, Faculty of Medicine, Tanta University.
2
Physical Medicine, Rheumatology & Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Abstract
Pruritus is a distressing symptom in many dermatological as well as systemic conditions, and it is sometimes very chronic and relapsing. Transcutaneous electrical nerve stimulation (TENS) is an inexpensive form of analgesia that could also ameliorate itching. This study aimed to evaluate TENS efficacy in patients with pruritus due to some types of chronic eczema, and in patients with chronic hepatic disease. Ten patients with atopic dermatitis (AD), 20 patients with lichen simplex chronicus (LSC), and 16 patients with chronic liver disease having chronic distressing pruritus received three sessions of TENS weekly for 12 sessions, and the effect on the visual analogue scale (VAS) scores was recorded after 2 weeks of therapy, at treatment end, and after an additional month for follow up. There was a statistically significant decline in the mean VAS score for studied groups at weeks 2 and 4 of therapy compared to baseline, but the improvement was more significant in patients with AD, and LSC (p < 0.001 for both) than in those with chronic liver disease (p < 0.01) who also showed an early re-elevation of VAS score on follow up. TENS therapy holds promise as a palliative, alternative, safe and inexpensive treatment for patients with some chronic pruritic conditions.
============================================================
26.) Dermatopathology in historical perspective: the Montgomery giant cell of lichen simplex chronicus.
===========================================================
Skinmed. 2010 Jan-Feb;8(1):54-5.
Rubakovic S1, Steffen C.
Author information
1
Internal Medicine, Rancho Mirage, CA, USA.
Abstract
In this short historical review, we will discuss the origin and references to the giant cell that is sometimes histopathologically present in the dermis of lichen simplex chronicus that was first described by Hamilton Montgomery, MD. A photomicrograph of the giant cell was included by Montgomery in his text Dermatopathology published in 1967. We will then provide a short biography of Montgomery.
===========================================================
===========================================================
Australas J Dermatol. 2016 Aug;57(3):210-5. doi: 10.1111/ajd.12308. Epub 2015 Mar 6.
Day T1,2, Bohl TG3, Scurry J2,4.
Author information
1
Maternity and Gynaecology, John Hunter Hospital, Newcastle, New South Wales.
2
University of Newcastle, Newcastle, New South Wales.
3
Solo Private Practice, Newborough, Victoria, Australia.
4
Anatomical Pathology, Pathology North, Hunter New England, Newcastle, New South Wales.
Abstract
OBJECTIVES:
To determine the diagnostic range of lichen dermatoses of the perianus, their extent, and response to treatment.
METHODS:
We reviewed perianal biopsies submitted to a tertiary referral pathology service between January 2010 and July 2014, interpreted as 'lichen' or 'lichenoid'. We collected data on patients' characteristics, referring specialty, extent of lesion and response to treatment.
RESULTS:
During the study period, 60 perianal biopsies met our inclusion criteria. The distribution of diagnoses was lichen sclerosus (LS) in 25/60 (42%), lichen simplex chronicus (LSC) in 23/60 (38%), lichen planus (LP) in 10/60 (17%), and a non-specific lichenoid reaction in 2/60 (3%). Eleven of 25 cases of LS (44%) showed superimposed LSC. Of 10 LP cases, nine (90%) were hypertrophic and three of these showed pseudoepitheliomatous hyperplasia; none were erosive LP. Compared with patients in the LS and LSC groups, those with LP were more likely to have a localised lesion. Topical steroids were prescribed in 91% cases with treatment data available, and 98% of treated patients who returned for follow up had improved or their disease was resolved.
CONCLUSIONS:
We encountered a spectrum of perianal lichen dermatoses, with LS, LP and LSC all represented. LS biopsied at the perianus is often lichenified. Hypertrophic LP is a common form of LP at the perianus.
=========================================================================
No hay comentarios:
Publicar un comentario
Tu comentario será objeto de revisión y luego aprobado.
Your comment will be revised and then approved.