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Neurodermatitis (Lichen Simplex Chronic)
Neurodermatitis (Lichen Simplex Chronic)
Definition
A chronic, severely pruritic disorder
Epidemiology
Lichen simplex chronicus affects adults,
Etiology
Pruritus can be caused by the by various
Pathomechanism
Lichen simplex chronicus is induced by
Clinical manifestation
Itching
First lession can be eritomatous plaque
Later became edema, erythema disappeared,
Clinical manifestation
The most common sites of involvement are
Histopatology
Hiperplasia epidermal,
Differential Diagnosis
Lichen simplex: erythemateous polygonal
Lichen
Neurodermatit
Differential Diagnosis
Psoriasis: Red, scaly, symmetrically
Psoriasis
Neurodermatit
Differential Diagnosis
Mycosis fungoides: Early lesion is
Mycosis
fungoides
Neurodermatit
Differential Diagnosis
Atopic dermatitis: In chronic, it can be
Atopic
Neurodermatit
Differential Diagnosis
Disease Efflorecenc
s
es
Location
Itch
sensation
Neurode
rmatitis
Lichenified,
scaly
plaques. May
develop to
hyper/hypopi
gmentation
Scalp, nape
of neck,
extensor
aspects of
extremities,
anogenital
Severe
Lichen
planus
Erythematou
s papules
with
Wickham
striae and
scales
Extremities
(flexural
areas),
thighs, lower
back, trunk,
and neck
Not always,
may be not
exist
Psoriasis
Erythematou
s plaques
with scaling
Extremities
(extensor
areas), scalp,
lower
lumbosacral,
buttocks, and
Varies among
patients;
usually found
at
erythrodermic
form; may
Other
symptoms
Nail
changes,
such as nail
pitting, and
arthritis
may be
Differential Diagnosis
Disease Efflorecenc
s
es
Location
Itch
sensation
Neurode
rmatitis
Lichenified,
scaly
plaques. May
develop to
hyper/hypopi
gmentation
Scalp, nape of
neck, extensor
aspects of
extremities,
anogenital
Severe
Mycosis Erythematou
fungoide s, scaly
s
macules.
Plaques may
arise.
Often
intense
Fever, chills,
weight loss,
malaise,
insomnia
due to
pruritus
Atopic
dermatit
is
Face and
extensor aspect
(infant)
Elbow and knee
flexures, sides
of neck, wrist,
Intense,
may get
worse in
early
evening
and night
Dry skin,
allergic
rhinitis and
asthma may
be found
Erythematou
s papules,
vesicles. Can
develop to
lichenificatio
n in chronic
Other
symptoms
Treatment
Treatment is aimed at interrupting the itch
scratch cycle.
first-line measures to control itch include
potent topical steroids as well as nonsteroidal
antipruritic preparations such as menthol,
phenol, or pramoxine
Intralesional steroid beneficial for thickend
plaque
Anti-histamint for abolish nighttime itch and
SSRIs for abolish daytime itch in patient OCD
Prognosis
The diseases run a chronic course
with persistence or recurrence of
lesions. Exacerbations occur in
response to emotional stress.
THANK
YOU
References
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References
Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th edition.