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Neurodermatitis, also known as lichen simplex chronicus, is a condition that appears on the skin and is similar to atopic dermatitis.

Scaly skin due to lichen simplex chronicus.

Scaly skin due to lichen simplex chronicus.

Neurodermatitis appears in patches. As a result of frequent rubbing and scratching, these patches tend to be thick and scaly and can be found on the neck, scalp, shoulders, feet and ankles, and wrists and hands.

Like atopic dermatitis, the itchy areas can become thick, discolored and marked. Unlike atopic dermatitis, the specific patches tend to always be present while the rest of the skin remains healthy.

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Thick, scaly, lesions can occur when the skin is repeatedly rubbed.

The cause of neurodermatitis is unknown, but certain triggers such as an insect bite and stress seem to play a role. In neurodermatitis, the nerves in the skin appear be overly ready to tell the brain that there is itch. Sometimes, neurodermatitis can occur with a skin allergy.

How is neurodermatitis treated?

Not scratching and rubbing the affected areas is key to healing the skin. Cutting fingernails very short and applying ice or an anti-itch preparation can be helpful in preventing scratching.

In some situations, performing patch testing to look for allergens and then avoiding those substances can help.

Like atopic dermatitis, neurodermatitis benefits from moisturizers to calm and protect the damaged skin. Heavy moisturizers may also help protect the area from rubbing and scratching.

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Chronic rubbing or scratching of the same area leads to lichen simplex chronicus, with thickened, rough, and sometimes red, broken skin areas.

Covering the skin (also known as occlusion) with socks, gloves, and even gauze wraps may also help the skin heal by disrupting the itch-scratch cycle and allowing the moisturizer to deeply penetrate. Unna boots (gauze impregnated with zinc oxide paste) are particularly helpful for neurodermatitis.

Topical corticosteroid medication can help calm the inflammation and itch. Because the skin tends to be very thick and scaly in neurodermatitis, stronger steroids may be required.

In cases where corticosteroids are not appropriate, or when they have been used for a long time, a non-corticosteroid topical medication such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed.

In severe cases, corticosteroids may be injected into the lesions to allow them to penetrate the thickened skin.

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