Lichen simplex chronicus
小结
定义
病史和体格检查
关键诊断因素
- 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
其他诊断因素
- 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
危险因素
- atopic diathesis
- environmental irritants
- psychiatric disorder
- dermatologic disease
- systemic conditions causing pruritus
诊断性检查
需考虑的检查
- 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
治疗流程
adults and children ≥12 years
children <12 years
撰稿人
作者
Brian L. Swick, MD
Clinical Professor
University of Iowa Departments of Dermatology and Pathology
Iowa City Veterans Affairs Medical Center
Iowa City
IA
利益声明
BLS declares that he has no competing interests.
同行评议者
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
利益声明
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
利益声明
HG declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Lotti T, Buggaiani G, Prignano F. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther. 2008;21:42-46.全文 摘要
Primary Care Dermatology Society. Lichen simplex (syn. circumscribed neurodermatitis). Jun 2022 [internet publication].全文
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.全文 摘要
American College of Obstetricians and Gynecologists. Practice bulletin no. 224: diagnosis and management of vulvar skin disorders. Jul 2020 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Hypertrophic lichen planus
- Hypertrophic actinic keratoses
- Squamous cell carcinoma of the skin
更多 鉴别诊断指南
- European guideline for the management of vulval conditions
- Lichen simplex (syn. circumscribed neurodermatitis)
更多 指南
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