Vulvar Disease pp 121-129 | Cite as

Lichen Simplex Chronicus

  • Despoina Mortaki
  • Alexander MortakisEmail author


Vulvar lichen simplex chronicus is a common dermatosis characterized by skin lichenification following excessive scratching. It is the end stage of an itch-scratch-itch cycle. The skin is thickened, erythematous, pale, or pigmented, with accentuated markings with normal skin (hatch markings). Once LSC has developed, it causes pruritus even without an alternative source, thus encouraging further scratching and continued worsening of the LSC in what is known as the “itch-scratch cycle.” Lichen simplex chronicus can be a primary dermatosis (the process arising de novo from normal skin), or secondary, presenting as a reaction to another vulvar disease, like lichen sclerosus, psoriasis, contact dermatitis, etc. Diagnosis of LSC is usually established on a clinical basis. Sometimes biopsy will be necessary to exclude underlying pathology. Treatment is aimed at identifying and eliminating the underlying cause, restoring the damaged epithelial barrier, and calming the inflammation with corticosteroids and other means. Even after the clearance of lesions, the condition can relapse. Some patients will need repeated management. Education of the patient is of utmost importance.


  1. 1.
    Lynch PJ. Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region. Dermatol Ther. 2004;17:8–19.CrossRefGoogle Scholar
  2. 2.
    Wilkinson E, Stone K. Atlas of vulvar diseases. Philadelphia: Lippincott Williams and Wilkins; 2008. p. 74–8.Google Scholar
  3. 3.
    Bornstein J, et al. The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) terminology of vulvar squamous intraepithelial lesions. J Lower Genit Tract Dis. 2016;20(1):11–4.CrossRefGoogle Scholar
  4. 4.
    Lebwohl MG, et al. Treatment of skin disease: comprehensive therapeutic strategies. 2nd ed. Philadelphia: Mosby/Elsevier; 2006.Google Scholar
  5. 5.
    Lynch PJ. Vulvar pruritus and lichen simplex chronicus. In: Black M, editor. Obstetric and gynecologic dermatology. Philadelphia: Mosby Elsevier; 2008. p. 157–66.CrossRefGoogle Scholar
  6. 6.
    Virgili A, et al. Evaluation of contact sensitization in vulvar lichen simplex chronicus. A proposal for a battery of selected allergens. J Reprod Med. 2003;48:33–6.PubMedGoogle Scholar
  7. 7.
    Crone AM, et al. Aetiological factors in vulvar dermatitis. J Eur Acad Dermatol Venereol. 2000;14:181–6.CrossRefGoogle Scholar
  8. 8.
    Liao YH, et al. Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort study. Br J Dermatol. 2014;170:890–4.CrossRefGoogle Scholar
  9. 9.
    Schlosser BJ. Contact dermatitis of the vulva. Dermatol Clin. 2010;28(4):697–706.CrossRefGoogle Scholar
  10. 10.
    Burrows LJ, et al. The vulvar dermatoses. J Sex Med. 2008;5:276–83.CrossRefGoogle Scholar
  11. 11.
    Lotti T, et al. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther. 2008;21:42–6.CrossRefGoogle Scholar
  12. 12.
    Rosenbaum MS, Ayllon T. The behavioral treatment of neurodermatitis through habit-reversal. Behav Res Ther. 1981;19:313–8.CrossRefGoogle Scholar
  13. 13.
    Moyal-Barracco M, Wendling J. Vulvar dermatoses. Best practice and research. Clin Obstet Gynecol. 2014;28:946–58.Google Scholar
  14. 14.
    Connor CJ, Eppsteiner EE. Vulvar contact dermatitis. Proc Obstet Gynecol. 2014;4(2):1–14.CrossRefGoogle Scholar
  15. 15.
    Guerrero A, Venkatesan A. Inflammatory vulvar dermatoses. Clin Obstet Gynecol. 2015;58(3):464–75.CrossRefGoogle Scholar
  16. 16.
    ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists, number 72, May 2006. Vaginitis. Obstet Gynecol. 2006;107:1195–206.CrossRefGoogle Scholar
  17. 17.
    Anderson MR, et al. Evaluation of vaginal complaints. JAMA. 2004;291:1368–79.CrossRefGoogle Scholar
  18. 18.
    Rodriguez M, Leclair C. Benign vulvar dermatoses. Obstet Gynecol Surv. 2012;67(1):55–63.CrossRefGoogle Scholar
  19. 19.
    Datz B, Yawalkar S. A double-blind, multicenter trial of 0.05% halobetasol propionate ointment and 0.05% clobetasol 17-propionate ointment in the treatment of patients with chronic, localized atopic dermatitis or lichen simplex chronicus. J Am Acad Dermatol. 1991;25:1157–60.CrossRefGoogle Scholar
  20. 20.
    Aschoff R, Wozel G. Topical tacrolimus for the treatment of lichen simplex chronicus. J Dermatolog Treat. 2007;18:115–7.CrossRefGoogle Scholar
  21. 21.
    Goldstein AT, et al. Pimecrolimus cream 1% for treatment of vulvar lichen simplex chronicus: an open-label, preliminary trial. Gynecol Obstet Investig. 2007;64:180–6.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University Hospital “A. Syggros” for Skin and Venereal DiseasesAthensGreece
  2. 2.“IASO” Maternity HospitalAthensGreece

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