Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- underlying dermatosis
- pruritus beginning during psychological stress
- severe intractable itching
- lichenification
- erythematous to violaceous plaques
- lesions on neck, ankles, scalp, vulva, scrotum, pubis, and extensor forearms
Outros fatores diagnósticos
- altered pigmentation
- erosions
- linear fissures
- grouped hyperpigmented papules on the shins
- hyperpigmented patch on the interscapular back
- underlying psychiatric disorder
- underlying systemic condition causing pruritus
Fatores de risco
- atopic diathesis
- environmental irritants
- psychiatric disorder
- dermatologic disease
- systemic conditions causing pruritus
Investigações diagnósticas
Investigações a serem consideradas
- skin biopsy
- patch testing
- potassium hydroxide preparation
- fungal culture
- skin scrapings
- serum TSH and free T4
- serum creatinine and BUN and electrolytes
- LFTs and gamma-GT
- CBC
Algoritmo de tratamento
adults and children ≥12 years
children <12 years
Colaboradores
Autores
Brian L. Swick, MD
Clinical Professor
University of Iowa Departments of Dermatology and Pathology
Iowa City Veterans Affairs Medical Center
Iowa City
IA
Declarações
BLS declares that he has no competing interests.
Revisores
Gil Yosipovitch, MD, FAAD
Professor
Stiefel Chair of Medical Dermatology
Director Miami Itch Center
Dr Phillip Frost Department of Dermatology and Cutaneous Surgery
Miller School of Medicine
University of Miami
Miami
FL
Declarações
GY is an advisory board member for Abbvie, Arcutis, Escient Health, Eli Lilly, Galderma, LEO Pharma, Novartis, Pfizer, Pierre Fabre, Regeneron Pharmaceuticals, Inc., Sanofi, Vifor, GSK, and Kamari. He has received grants/research funding from Eli Lilly, LEO Pharma, Novartis, Pfizer, Galderma, Escient, Sanofi Regeneron, and Celldex. GY is an investigator for Regeneron Pharmaceuticals, Inc., and Sanofi.
Helen Goodyear, MBChB, MRCP, FRCPCH, MD, MMed
Consultant Paediatrician
Heartlands Hospital
Birmingham
UK
Declarações
HG declares that she has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Lotti T, Buggaiani G, Prignano F. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther. 2008;21:42-46.Texto completo Resumo
Primary Care Dermatology Society. Lichen simplex (syn. circumscribed neurodermatitis). Jun 2022 [internet publication].Texto completo
van der Meijden WI, Boffa MJ, Ter Harmsel B, et al. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2022 Jul;36(7):952-72.Texto completo Resumo
American College of Obstetricians and Gynecologists. Practice bulletin no. 224: diagnosis and management of vulvar skin disorders. Jul 2020 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Hypertrophic lichen planus
- Hypertrophic actinic keratoses
- Squamous cell carcinoma of the skin
Mais Diagnósticos diferenciaisDiretrizes
- European guideline for the management of vulval conditions
- Lichen simplex (syn. circumscribed neurodermatitis)
Mais Diretrizes
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