Lichen simplex chronicus is characterized by thickened lichenified plaques that result from long-standing rubbing or scratching; often develops in patients with atopic dermatitis or chronic contact dermatitis.
Clinical presentation of lichen simplex chronicus
Lichen simplex chronicus can occur in patients with history, namely, personal history of bronchial asthma and/or allergic rhinitis. There may be family history of atopy. However, this is not a consistent or pathognomic feature of the condition. It can present clinically as isolated or multiple lichenified thickened plaques that are usually hyper pigmented and excoriated with accentuated skin markings.
Patients are often concerned with the intense Pruritus and the physical disfigurement. Lesions are often found on areas accessible to the patients, namely, the neck, the anogenital areas, and the upper and lower extremities.
Lichen simplex chronicus should be differentiated from a plaque of psoriasis and lichen planus. A plaque of lichen planus will have papules of lichen planus at the periphery of the lesion, its purplish color and Wickham’s striae are other differentiating points.
Psoriatic plaques will be more scaly; there may be lesions of psoriasis elsewhere on the skin.
Diagnosis of lichen simplex chronicus
The diagnosis is readily apparent and is made on clinical grounds. It is based on recognizing the characteristic morphology of the lesion developing at the sites of prediction. It may be supplemented by histopathological examination that reveals the following:
- Marked hyperkeratosis
- Marked acanthosis
- Lengthening of the rete ridges
- Hyperplasia of all components of the epidermis
- Chronic inflammatory infiltrate in the dermis
- Silver impregnation shows proliferation of the schwann’s cells.
Homeopathic treatment for lichen simplex chronicus
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat lichen simplex chronicus but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat lichen simplex chronicus that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of lichen simplex chronicus:
Anantherum, Arsenic Album, Belladonna, Calendula, Juglans Cinerea, Kreosote, Ledum Pal, Lycopodium, Phytolacca, Rumex, Sulphur, Alumina, Ammonium Mur, Antim Crud, Apis Mel, Bovista, Bryonia, Dulcamara, Kali Ars, Lachesis, Mercurius, Natrum Carb, Sepia, Sulphuric Acid, Thuja and many other medicines.