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Prurigo Nodularis and LSC

Prurigo Nodularis (PN) and Lichen Simplex Chronicus (LSC) are surprisingly common conditions which result from the skin reacting to trauma or irritation. When an area of skin is repeatedly scratched, rubbed or ‘picked’, it responds by building up rough, callus-like scaling.

Patients with prurigo nodularis or LSC generally fall into one of two categories; there are those who know they’re picking/scratching, and those who don’t.

Prurigo Nodularis and LSC Diagram

If you know that you’re picking or scratching, the question is…why? Most often what happens is that patients start off with another source of inflammation such as a bug bite or allergic reaction, but then due to habitually scratching, prurigo nodularis or LSC occurs as a result. If that’s the case, then we can help by providing medications which help to stop the inflammation and itching sensation which created this ‘itch-scratch’ cycle in the first place. However, if you either pick at your skin purely out of ‘habit’, or even worse, you don’t even realize you’re scratching at all, then it can be very difficult for us to treat.

So if you are aware that you are repeatedly scratching or rubbing, please do everything in your power to stop.

If you don’t know that you are scratching or rubbing, then you might be doing it in your sleep. Ask family members if they notice it. Sometimes patients will tell us that they find themselves scratching or picking when they are worried or stressed. When this happens, if dermatological measures fail to provide satisfactory improvement, it is sometimes recommended that the patient speak to their PCP about receiving treatment for stress and anxiety.