Lichen Simplex Chronicus Itch: An Update

Authors

  • Teresa Ju University of Miami Miller School of Medicine
  • Ashley Vander Does
  • Noreen Mohsin
  • Gil Yosipovitch Dr Phillip Frost Department of Dermatology, University of Miami, 1150 NW 14th St, Miami, FL 33136, USA

DOI:

https://doi.org/10.2340/actadv.v102.4367

Keywords:

itch, lichen simplex chronicus, physiopathology, pruritus

Abstract

Lichen simplex chronicus is a form of chronic localized pruritus with a secondary dermatitis, and one of the most common types of chronic itch conditions, estimated to affect more than 10% of the general population. However, despite its prevalence and burden, there has been limited research into the pathogenesis and aetiology of lichen simplex chronicus, which, historically, made it a challenging condition to treat. In recent years, our understanding of this condition, along with that of pruritus and the itch-scratch cycle, has increased greatly, enabling a substantial increase in treatment options. In addition, there are several new promising treatments currently in development and trials. This article discusses the definition, epidemiology, clinical characteristics, pathophysiology, and current therapeutic options for lichen simplex chronicus, in order to highlight recent advancements in this field.

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References

Yosipovitch G, Bernhard JD. Clinical practice. Chronic pruritus. N Engl J Med 2013; 368: 1625-1634.

https://doi.org/10.1056/NEJMcp1208814

Tianco EA, Buendia-Teodosio G, Alberto NL. Survey of skin lesions in the Filipino elderly. Int J Dermatol 1992; 31: 196-198.

https://doi.org/10.1111/j.1365-4362.1992.tb03935.x

Mack MR, Kim BS. The itch-scratch cycle: a neuroimmune perspective. Trends Immunol 2018; 39: 980-991.

https://doi.org/10.1016/j.it.2018.10.001

Charifa A, Badri T, Harris BW. Lichen simplex chronicus. Treasure Island (FL): StatPearls Publishing; 2022.

Crone AM, Stewart EJ, Wojnarowska F, Powell SM. Aetiological factors in vulvar dermatitis. J Eur Acad Dermatol Venereol 2000; 14: 181-186.

https://doi.org/10.1046/j.1468-3083.2000.00080.x

Leow Y-H, Yosipovitch G. Pruritus in lichen simplex chronicus and lichen amyloidosis. Basic Clin Dermatol 2004; 27: 255-258.

Golpanian RS, Fourzali K, Fowler E, Kursewicz CD, Lipman Z, Chan YH, et al. The pleasurability of scratching an itch amongst different pruritic conditions. Acta Derm Venereol 2020; 100: adv00254.

https://doi.org/10.2340/00015555-3605

Cevikbas F, Wang X, Akiyama T, Kempkes C, Savinko T, Antal A, et al. A sensory neuron-expressed IL-31 receptor mediates T helper cell-dependent itch: involvement of TRPV1 and TRPA1. J Allergy Clin Immunol 2014; 133: 448-460.

https://doi.org/10.1016/j.jaci.2013.10.048

Qiu Y, Tang N, Zhang W, Xiong JX, Hu L, Cai T. Down-regulated expression of transient receptor potential ankyrin 1 in lichen simplex chronicus. Ann Palliat Med 2020; 9: 3757-3765.

https://doi.org/10.21037/apm-20-1712

Zhao J, Munanairi A, Liu XY, Zhang J, Hu L, Hu M, et al. PAR2 mediates itch via TRPV3 signaling in keratinocytes. J Invest Dermatol 2020; 140: 1524-1532.

https://doi.org/10.1016/j.jid.2020.01.012

Wilson SR, Thé L, Batia LM, Beattie K, Katibah GE, McClain SP, et al. The epithelial cell-derived atopic dermatitis cytokine TSLP activates neurons to induce itch. Cell 2013; 155: 285-295.

https://doi.org/10.1016/j.cell.2013.08.057

Cui S, Xiao T, Wang Y, Lu H, Wang Y, Gao XH, et al. Morphological relationship between nerve fibers and Langerhans cells in the epidermis of psoriasis vulgaris and lichen simplex chronicus. J Dermatol Sci 2009; 56: 132-134.

https://doi.org/10.1016/j.jdermsci.2009.07.009

Sorour NE, Elesawy FM, Tabl HA, Ibrahim ME, Akl EM. Evaluation of serum levels of neurotrophin 4 and brain-derived nerve growth factor in uremic pruritus patients. Clin Cosmet Investig Dermatol 2019; 12: 109-114.

https://doi.org/10.2147/CCID.S190917

Altunay İ K, Özkur E, Uğurer E, Baltan E, Aydın Ç, Serin E. More than a skin disease: stress, depression, anxiety levels, and serum neurotrophins in lichen simplex chronicus. An Bras Dermatol 2021; 96: 700-705.

https://doi.org/10.1016/j.abd.2021.04.011

Sandoval M, Parra J, Reyna-Jeldes M, Curi-Tuma M, Espinoza F, Muñoz D, et al. Itch in lichen simplex chronicus is associated with localized small fiber neuropathy. J Invest Dermatol 2022; 142: 731-735.e3.

https://doi.org/10.1016/j.jid.2021.08.429

Yosipovitch G, Misery L, Proksch E, Metz M, Ständer S, Schmelz M. Skin barrier damage and itch: review of mechanisms, topical management and future directions. Acta Derm Venereol 2019; 99: 1201-1209.

https://doi.org/10.2340/00015555-3296

Burgin S. Chapter 15. Nummular eczema, lichen simplex chronicus, and prurigo nodularis. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick's dermatology in general medicine, 8th edn. New York, NY: The McGraw-Hill Companies; 2012.

Goldstein AT, Thaçi D, Luger T. Topical calcineurin inhibitors for the treatment of vulvar dermatoses. Eur J Obstet Gynecol Reprod Biol 2009; 146: 22-29.

https://doi.org/10.1016/j.ejogrb.2009.05.026

Remitz A, Harper J, Rustin M, Goldschmidt WF, Palatsi R, van der Valk PG, et al. Long-term safety and efficacy of tacrolimus ointment for the treatment of atopic dermatitis in children. Acta Derm Venereol 2007; 87: 54-61.

https://doi.org/10.2340/00015555-0167

Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I. Treatment of skin disease e-book: comprehensive therapeutic strategies. Elsevier Health Sciences, Amsterdam; 2013.

Greaves MW. Recent advances in pathophysiology and current management of itch. Ann Acad Med Singap 2007; 36: 788-792.

Drake LA, Millikan LE. The antipruritic effect of 5% doxepin cream in patients with eczematous dermatitis. Doxepin Study Group. Arch Dermatol 1995; 131: 1403-1408.

https://doi.org/10.1001/archderm.1995.01690240065010

Yosipovitch G, Sugeng MW, Chan YH, Goon A, Ngim S, Goh CL. The effect of topically applied aspirin on localized circumscribed neurodermatitis. J Am Acad Dermatol 2001; 45: 910-913.

https://doi.org/10.1067/mjd.2001.117399

Lee HG, Grossman SK, Valdes-Rodriguez R, Berenato F, Korbutov J, Chan YH, et al. Topical ketamine-amitriptyline-lidocaine for chronic pruritus: a retrospective study assessing efficacy and tolerability. J Am Acad Dermatol 2017; 76: 760-761.

https://doi.org/10.1016/j.jaad.2016.10.030

Nattkemper LA, Zhi K, Romero KE, Shah SM, Ju T, Fourzali K, et al. Antipruritic effect of topical acetaminophen gel in histaminergic and non-histaminergic itch provocation: a double-blind, vehicle-controlled pilot study. Acta Derm Venereol 2022; 102: adv00640.

https://doi.org/10.2340/00015555-3910

Ju T, Labib A, Vander Does A, Yosipovitch G. Topical Janus kinase-signal transducers and activators of transcription inhibitor tofacitinib is effective in reducing nonatopic dermatitis chronic itch: a case series. J Am Acad Dermatol 2022; 87: 400-403.

https://doi.org/10.1016/j.jaad.2022.03.012

Gencoglan G, Inanir I, Gunduz K. Therapeutic hotline: treatment of prurigo nodularis and lichen simplex chronicus with gabapentin. Dermatol Ther 2010; 23: 194-198.

https://doi.org/10.1111/j.1529-8019.2010.01314.x

More on mu-opioid receptor antagonists in PD-1 blockade-induced pruritus. N Engl J Med 2019; 380: 601-602.

https://doi.org/10.1056/NEJMc1815143

Lynch PJ. Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region. Dermatol Ther 2004; 17: 8-19.

https://doi.org/10.1111/j.1396-0296.2004.04002.x

Hundley JL, Yosipovitch G. Mirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study. J Am Acad Dermatol 2004; 50: 889-891.

https://doi.org/10.1016/j.jaad.2004.01.045

Sanjana V, Fernandez R. Evaluation of an antihistamine and an antidepressant for the treatment of lichen simplex chronicus. Ind J Dermatol Venereol Leprol 1992; 58: 384-387.

Qureshi AA, Abate LE, Yosipovitch G, Friedman AJ. A systematic review of evidence-based treatments for prurigo nodularis. J Am Acad Dermatol 2019; 80: 756-764.

https://doi.org/10.1016/j.jaad.2018.09.020

Juarez MC, Kwatra SG. A systematic review of evidence based treatments for lichen simplex chronicus. J Dermatolog Treat 2021; 32: 684-692.

https://doi.org/10.1080/09546634.2019.1708856

Esen Salman K, Kıvanç Altunay İ, Salman A. The efficacy and safety of targeted narrowband UVB therapy: a retrospective cohort study. Turk J Med Sci 2019; 49: 595-603.

https://doi.org/10.3906/sag-1810-110

Engin B, Tufekci O, Yazici A, Ozdemir M. The effect of transcutaneous electrical nerve stimulation in the treatment of lichen simplex: a prospective study. Clin Exp Dermatol 2009; 34: 324-328.

https://doi.org/10.1111/j.1365-2230.2008.03086.x

Wu C, Zou M, Xiong Y, Wang L, Chen H, Fan Y, et al. Short- and long-term efficacy of focused ultrasound therapy for non-neoplastic epithelial disorders of the vulva. BJOG 2017; 124: 87-92.

https://doi.org/10.1111/1471-0528.14747

Ständer S, Yosipovitch G, Legat FJ, Lacour JP, Paul C, Narbutt J, et al. Trial of nemolizumab in moderate-to-severe prurigo nodularis. N Engl J Med 2020; 382: 706-716.

https://doi.org/10.1056/NEJMoa1908316

Study of Dupilumab for the Treatment of Patients With Prurigo Nodularis, Inadequately Controlled on Topical Prescription Therapies or When Those Therapies Are Not Advisable (LIBERTY-PN PRIME). ClinicalTrials.gov identifier: NCT 04183335. Updated February 17, 2022. [Accessed April 3, 2022] Available from https://clinicaltrials.gov/ct2/show/NCT04183335.

A Study to Assess the Efficacy, Safety, and Tolerability of KPL-716 in Reducing Pruritus in Chronic Pruritic Diseases. ClinicalTrials.gov identifier: NCT03858634. Updated December 28, 2021. [Accessed April 3, 2022] Available from https://ClinicalTrials.gov/show/NCT03858634.

Kamari Pharma L, Bioskin Gmb H. KM-001 Cream for Treatment of Pruritus in Adult Patients With Lichen Simplex Chronicus (LSC). ClinicalTrials.gov identifier: NCT05454462. Updated July 12, 2022. [Accessed July 13, 2022] Available from https://clinicaltrials.gov/ct2/show/NCT05454462.

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Published

2022-10-19

How to Cite

Ju, T., Vander Does, A., Mohsin, N., & Yosipovitch, G. . (2022). Lichen Simplex Chronicus Itch: An Update. Acta Dermato-Venereologica, 102, adv00796. https://doi.org/10.2340/actadv.v102.4367