Lichen Simplex

Patients will describe intense itching, especially in localized areas such as the neck, wrists, genital area and lower legs. They may report a history of scratching or rubbing the affected areas due to the discomfort, leading to thickened skin. 

Examine for well-demarcated, lichenified (thickened and leathery) patches, often with hyperpigmentation in Black skin. The skin may show excoriations (scratch marks) and possible secondary infections from repeated scratching. 

• Topical Steroids (e.g., Clobetasol 0.05% cream): Apply once or twice daily for 2-4 weeks to reduce inflammation.

• Topical Calcineurin Inhibitors (e.g., Tacrolimus 0.1% ointment): Use twice daily as an alternative for sensitive areas.

• Emollients (e.g., Eucerin cream): Apply regularly to hydrate the skin and prevent further irritation.