Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- dermatose subjacente
- prurido com início durante estresse psicológico
- prurido intenso intratável
- liquenificação
- placas eritematosas a violáceas
- lesões no pescoço, tornozelos, couro cabeludo, vulva, escroto, púbis e antebraços extensores
Other diagnostic factors
- pigmentação alterada
- erosões
- fissuras lineares
- pápulas hiperpigmentadas agrupadas nas canelas
- manchas hiperpigmentadas na região interescapular das costas
- transtorno psiquiátrico subjacente
- condição sistêmica subjacente que provoca prurido
Risk factors
- diátese atópica
- agentes irritantes ambientais
- transtorno psiquiátrico
- doença dermatológica
- condições sistêmicas que causam prurido
Diagnostic investigations
Investigations to consider
- biópsia de pele
- teste de contato
- preparação de hidróxido de potássio
- cultura fúngica
- raspagem de pele
- hormônio estimulante da tireoide (TSH) e T4 livre séricos
- ureia e creatinina séricas e eletrólitos
- testes da função hepática e gama-glutamiltransferase
- Hemograma completo
Treatment algorithm
adultos e crianças ≥12 anos
crianças com idade <12 anos
Contributors
Authors
Brian L. Swick, MD
Clinical Professor
University of Iowa Departments of Dermatology and Pathology
Iowa City Veterans Affairs Medical Center
Iowa City
IA
Disclosures
BLS declares that he has no competing interests.
Peer reviewers
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
Disclosures
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
Disclosures
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.
References
Key articles
Lotti T, Buggaiani G, Prignano F. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther. 2008;21:42-46.Full text Abstract
Primary Care Dermatology Society. Lichen simplex (syn. circumscribed neurodermatitis). Jun 2022 [internet publication].Full text
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.Full text Abstract
American College of Obstetricians and Gynecologists. Practice bulletin no. 224: diagnosis and management of vulvar skin disorders. Jul 2020 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Líquen plano hipertrófico
- Ceratose actínica hipertrófica
- Carcinoma de células escamosas da pele
More DifferentialsGuidelines
- Lichen simplex (syn. circumscribed neurodermatitis)
- European guideline for the management of vulval conditions
More Guidelines
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