Page 50 - LECTURE NOTES

Pruritus is usually described as much worse during periods of inactivity, usually at

bedtime and during the night. Touch and emotional stress also may provoke pruritus,
which is relieved by moderate-to-severe rubbing and scratching.

LSC occurs mostly in mid-to-late adulthood, with highest prevalence in persons aged

30-50 years.

9 Scalp, Nape of neck,
9 Extensor forearms and elbows

9 Vulva and scrotum
9 Upper medial thighs, knees, lower legs, and ankles

lichenified, firm, rough plaques with exaggerated skin lines are noted.

Pigmentary changes (especially hyperpigmentation) are seen variably as in any
dermatitic lesion.

Treatment is aimed at reducing pruritus and minimizing existing lesions because
rubbing and scratching cause LSC.

Topical steroids are the current treatment of choice because they decrease
inflammation and itch while concurrently softening the hyperkeratosis. Because lesions

are by nature chronic, treatment most likely is very long.

Occasionally, occlusion is used to increase potency and enhance delivery of the

steroids and also provides a physical barrier to the scratching.

Keratolytes (2% - 3% Salicylic acid) could be used in lichenfied lesion to remove the

hyperkeratosis.

3.11. Acne vulgaris

Acne vulgaris is a common skin disease that affects 85-100% of people at some time
during their lives. It is characterized by noninflammatory follicular papules or

comedones and by inflammatory papules, pustules, and nodules in its more severe

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