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.