A systematic review of evidence based treatments for lichen simplex chronicus.

Lichen simplex chronicus (LSC) is a disorder characterized by thickened areas of skin from repeated rubbing or scratching. The multifactorial nature of LSC makes management difficult and there are currently no evidence-based guidelines for treatment. We conducted a systematic review of the literature to evaluate treatments for LSC and provide an evidence-based summary of the current treatments as well as highlight novel therapies. A total of 21 studies were included which comprised 682 patients with LSC involving various areas. The most robust evidence was seen with the use of topical corticosteroids (n = 7 RCTs) and limited data suggest benefit with other treatments such as topical immunomodulators, topical antipruritic agents, oral antihistamines, antiepileptics and antidepressants. We also discuss novel treatment approaches using transcutaneous electrical nerve stimulation, focused ultrasound, and phototherapy. Despite emerging evidence there remains a paucity of high-quality studies supporting treatments for LSC and larger controlled trials are needed.

Therapeutic hotline: Treatment of prurigo nodularis and lichen simplex chronicus with gabapentin.

Psychocutaneous conditions are frequently encountered in dermatology practice. Prurigo nodularis and lichen simplex chronicus are two frustrating conditions that are classified in this category. They are often refractory to classical treatment with topical corticosteroids and antihistamines. Severe, generalized exacerbations require systemic therapy. Phototherapy, erythromycine, retinoids, cyclosporine, azathiopurine, naltrexone, and psychopharmacologic agents (pimozide, selective serotonin reuptake inhibitor antidepressants) were tried with some success. Here five cases with lichen simplex chronicus and four cases with prurigo nodularis, who responded well to gabapentin, are presented.

Treatment of the localized neurodermatitis by plum-blossom needle tapping and with the modified yangxue dingfeng tang--a clinical observation of 47 cases.

OBJECTIVE: To observe the therapeutic effects of plum-blossom needle tapping combined with the modified yangxue dingfeng tang (a decoction for nourishing the blood and expelling wind) for the localized neurodermatitis. METHODS: 141 cases of the localized neurodermatitis were randomly divided into 3 groups. Forty-seven patients in the treatment group received local tapping and oral medication of the modified yangxue dingfeng tang which consisted of sheng di huang ([Chinese characters: see text] Radix Rehmanniae), dang gui ([Chinese characters: see text] Radix Angelicae Sinensis), chi shao ([Chinese characters: see text] Radix Paeoniae Rubra), tian dong ([Chinese characters: see text] Radix Asparagi), mai dong ([Chinese characters: see text] Radix Ophiopogonis), jiang can ([Chinese characters: see text] Bombyx Batryticatus), mu dan pi ([Chinese characters: see text] Cortex Moutan), chuan xiong ([Chinese characters: see text] Rhizoma Chuanxiong), he shou wu ([Chinese characters: see text] Radix Polygoni Multiflori), and quan xie ([Chinese characters: see text] Scorpio). Forty-seven patients in the control group I were simply given the modified yangxue dingfeng tang; and 47 patients in the control group II were treated with oral benadryl and Vitamin C plus local external application of 10% urea ointment. The treatment course for all the 3 groups lasted 30 days. RESULTS: The short-term and long-term effects for the treatment group were much better than those of the 2 control groups (P < 0.05). CONCLUSION: The plum-blossom needle tapping plus the modified yangxue dingfeng tang exhibits a better and stable effect for the localized neurodermatitis.

Homoeopathy for the treatment of lichen simplex chronicus: a case series.

Twenty-seven patients with chronic lichen simplex involving various parts of the body were treated. Hydrocotyle was prescribed to 21 patients in different potencies (6c, 30c, 200c, 1 M, 10 M), Thuja to three patients (1 M, 10 M), Graphites (6c), Kali bich (30c) and Sulphur (200c) to one patient each during 1 year study period. Only two patients showed complete improvement with Thuja and one with Graphites. In other cases, the response was limited to partial relief of [corrected] itching.

Transmittance properties of flurandrenolide tape for psoriasis: helpful adjunct to phototherapy.

BACKGROUND: Flurandrenolide tape is a valuable agent in the treatment of lichen simplex chronicus and in psoriasis. The corticosteroid is helpful for reducing the symptoms and induration of the lichen simplex chronicus lesion, and occlusion of the lesion with the tape reduces the patient's opportunity to rub and scratch the affected area. OBJECTIVES: The purpose of this study was to determine to what extent flurandrenolide tape may block ultraviolet (UV) light and interfere with phototherapy of psoriasis. METHODS: Flurandrenolide tape was applied to quartz spectroscopy cuvettes, and the absorption spectrum was determined using a Beckman DU-600 spectrophotometer. The effect of the tape on UV light transmission was also determined using our UVA-UVB office phototherapy unit. RESULTS: Flurandrenolide tape has considerable UV absorption in the UVC range with less absorption in the UVB and UVA range. The transmittance is greater (less absorption) with longer wavelengths. There was greater UV absorption in the UVB range than in the UVA range. CONCLUSION: Although flurandrenolide tape may be left in place during PUVA therapy, adjustment of UV dose or removal of the tape is probably needed during UVB phototherapy.

[Comparative testing of Kamillosan cream and steroidal (0.25% hydrocortisone, 0.75% fluocortin butyl ester) and non-steroidal (5% bufexamac) dermatologic agents in maintenance therapy of eczematous diseases]. / Vergleichende Prüfung von Kamillosan Creme gegenüber steroidalen (0,25% Hydrocortison, 0,75% Fluocortinbutylester) und nichtsteroidalen (5% Bufexamac) Externa in der Erhaltungstherapie von Ekzemerkrankungen.

We report on 161 patients suffering from inflammatory dermatoses on hands, forearms, and lower legs who had been initially treated with 0.1% difluocortolone valerate. During the maintenance therapy carried out over a period of 3 to 4 weeks, we tested the efficacy of Kamillosan cream vs. 0.25% hydrocortisone, 0.75% fluocortin butyl ester, and 5% bufexamac in a bilateral comparative study. For the indications tested Kamillosan cream showed more or less equieffective therapeutic results as compared to 0.25% hydrocortisone. It is superior, however, to the non-steroidal anti-inflammatory agent 5% bufexamac as well as to 0.75% fluocortin butyl ester, a further glucocorticoid. With regard to neurodermitis, Kamillosan cream not only shows the same therapeutic effect as 0.25% hydrocortisone but is even of marked superiority towards other reference products.