50 yo M with DM & HTN presents with a 6-month history of generalized pruritus. He reports that he scratches frequently. On examination his skin is dry and scaly. He has multiple linear excoriations and thickened skin on his forearms, legs, and neck.
Dx: Lichen simplex chronicus.
Lichen simplex chronicus consists of lichenified plaques and excoriations that result from excessive scratching. Treatment focuses on stopping the itch-scratch cycle. Topical corticosteroids under an occlusive dressing or intralesional corticosteroids can be helpful.
Moses S: Pruritus. Am Fam Physician 2003;68(6):1135-1142