Mashoudy Kayla D, Ye-Tay Joselyn, Kim Sarah, Khalil Nicole, Yosipovitch Gil
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA.
Department of Pediatrics, Nicklaus Children's Hospital, Miami, USA.
Acta Derm Venereol. 2025 Sep 4;105:adv43776. doi: 10.2340/actadv.v105.43776.
Lichen simplex chronicus is a chronic pruritic skin condition that significantly impacts quality of life. This retrospective study analysed 125 patients with clinically confirmed lichen simplex chronicus seen at a tertiary academic centre to characterize itch severity, anatomical distribution, and associated comorbidities. Itch intensity was assessed using the Numerical Rating Scale (NRS), and clinical data were stratified by demographics and disease extent. Most patients (75%) reported moderate-to-severe itch (NRS 4-10), with nearly 90% experiencing daily pruritus and half reporting both daytime and nocturnal symptoms. The limbs were the most commonly affected sites. Comorbid conditions were frequent, including generalized anxiety disorder (50% vs ~3% in the US adult population), major depressive disorder (44% vs ~8%), hypertension (61% vs ~45%), and type 2 diabetes (30% vs ~11%). Patients with multiple-lesion lichen simplex chronicus had significantly higher itch severity (mean NRS 7.81 vs 7.08, p = 0.001) and were more likely to be female (81% vs 46%, p = 0.002) compared with those with localized disease. These findings highlight the high symptom burden and frequent co-occurrence of psychiatric and metabolic comorbidities in lichen simplex chronicus. Thus, early identification and management of psychiatric, neurological, and metabolic conditions may improve outcomes for patients with lichen simplex chronicus.
慢性单纯性苔藓是一种慢性瘙痒性皮肤病，严重影响生活质量。这项回顾性研究分析了在一家三级学术中心就诊的125例临床确诊为慢性单纯性苔藓的患者，以确定瘙痒严重程度、解剖分布及相关合并症。使用数字评定量表（NRS）评估瘙痒强度，并根据人口统计学和疾病范围对临床数据进行分层。大多数患者（75%）报告有中度至重度瘙痒（NRS 4-10），近90%的患者每天都有瘙痒，半数患者报告有白天和夜间症状。四肢是最常受累的部位。合并症很常见，包括广泛性焦虑障碍（50%，而美国成年人口中约为3%）、重度抑郁症（44%，而美国成年人口中约为8%）、高血压（61%，而美国成年人口中约为45%）和2型糖尿病（30%，而美国成年人口中约为11%）。与局限性疾病患者相比，多病灶慢性单纯性苔藓患者的瘙痒严重程度明显更高（平均NRS 7.81对7.08，p = 0.001），且更可能为女性（81%对46%，p = 0.002）。这些发现凸显了慢性单纯性苔藓患者的高症状负担以及精神和代谢合并症的频繁共现。因此，早期识别和管理精神、神经和代谢疾病可能会改善慢性单纯性苔藓患者的治疗效果。
