Lichen simplex chronicus is a skin disorder characterized by chronic itching and scratching. The constant scratching causes thick, leathery, brownish skin.

This is a skin disorder characterized by a self-perpetuating scratch-itch cycle:

• It may begin with something that rubs, irritates, or scratches the skin, such as clothing.
• This causes the person to rub or scratch the affected area. Constant scratching causes the skin to thicken.
• The thickened skin itches, causing more scratching, causing more thickening.
• The skin may become leathery and brownish in the affected area.

This disorder may be associated with atopic dermatitis (eczema) or psoriasis. It may also be associated with nervousness, anxiety, depression, and other psychologic disorders.

It is common in children, who chronically scratch insect bites and other areas. It can also be common in mentally retarded children who have chronic repetitive movements.

• Itching of the skin
  • May be chronic
  • May be intense
  • Increases with nervous tension, stress
• Skin lesion, patch, or plaque
  • Exaggerated skin lines over the lesion
  • Circumscribed lesion with distinct borders
  • Skin lesion becomes leathery textured (lichenification)
  • Darkened (hyperpigmented) or reddened skin
  • Excoriation, raw areas
  • Scratch marks
  • Scaling
  • Commonly located on the ankle, wrist, neck, rectum/anal area, forearms, thighs, lower leg, back of the knee, inner elbow

The diagnosis is primarily based on the appearance of the skin and a history of chronic itching and scratching. A skin lesion biopsy may be needed to confirm the diagnosis.