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Therapeutic Approach

Lichen simplex chronicus (LSC) is a chronic, severely pruritic disorder characterized by one or more lichenified plaques. LSC most commonly affects the scalp, nape of neck, extensor aspects of extremities, ankles, and anogenital area. Therapy should be aimed at interrupting the itch–scratch cycle.1 Systemic causes of itch should also be identified and addressed. In the authors’ experience, first-line treatment is topical high-potency corticosteroids. The literature also supports use of topical doxepin. In patients with a small number of lesions, intralesional triamcinolone may be considered. While the literature does not strongly support it, gabapentin may be utilized as a systemic treatment. See Table 2-1.

Table 2-1Lichen Simplex Chronicus Treatment Table

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