REFERAT

NEURODERMATITIS
(LICHEN SIMPLEX CHRONIC)

JAQUELINE MAWARNI EFFENDY (2017-84-044)

SUPERVISOR :
dr. Hanny Tanasal, Sp.KK

PRESENTED AS ASSIGMENT TO FULL FILL REQUIREMENT OF CLINICAL CO ASSISTANCE

IN DEPARTEMENT OF DERMATOVENEROLOGY RSUD DR. M. HAULUSSY
MEDICAL FACULTY OF PATTIMURA UNIVERSITY
AMBON
2017
 DEFINITION

Neurodermatitis or lichen simplex chronic is a chronic inflammation

in the skin with a pruritus disorder and a special localized form of
lichenification occurring in circumscribed plaques.
 EPIDEMIOLOGIC
The highest prevalence is middle to late adult-hood with a peak at 30 50 years.

The distribution according the gander show the ratio female/ male to 1.2 : 1

Result from distribution according the age show two peaks of LSH: over 65 years of age 11,87%.
Range 25 30 years 10.75%

The result of the comparison of age and gander of the patients show that in younger age group most
of patients are female and this ratio changes with increasing of age in favor of male

In group 25 30 yeas the ratio female / male is 1,7 : 1

At the age 65 up years ratio female / male is 1 : 2,3

 Etiology and pathogenesis
Lichen simplex chronic is induced by rubbing and starching secondary to itch.

Environmental factors have been implicated in inducing itch, such as heat,

sweat and irritation.

Emotional factor or psychological factor in patient association with lichen

simplex chronic
 Etiology and pathogenesis
Neurotransmitters that affect mood, such as dopamine, serotonin, or opioid
peptides modulated perception of itch via descending spinal pathway

Nerve growth factor is produced and released by mast cell, which are increase
in number and size in histologic section

It upregulates the expression of neuropeptide, such as calcitonin generelated

peptide and substance P. this are thought to mediated inflammation and itch.
Clinical manifestation
Severe itching is the hallmark of lichen
simplex chronicus
Itching is severity worse with sweating, heat
or irritation from clothing
Repeat rubbing and stretching gives rise to
lichenified, scaly plaque with excoriation
Clinical manifestation
The most common site of involvement are
scalp, the nape of neck, the ankles, the
extensor aspects of the extremities, and the
anogenital region.
The labia majora in women and the scrotum
in men are the most common site of genital
involvement.
Clinical manifestation
The common site of lichen simplex chronic
in the nape of neck usually found in women.
Small plaque from the nape of neck can be
extends to the scalp.
Usually will form like a skuama that can be
found in psoriasis.
Differential Diagnosis
ATOPIC DERMATITIS
Differential Diagnosis
PSORIASIS
Differential Diagnosis
LICHEN PLANUS
 THERAPY
Treatment is aimed at interrupting the itch-scratch cycle

First line therapy measures to control itch include potential topical steroids as well as non
steroidal antipruritic preparation such as menthol, phenol, or pramoxine

Topical tacrolimus

Sedating antihistamin such as hydroxyzine, or tricyclic antidepresan, such as doxepin.