A case of neurodermatitis circumscipta of scalp presenting as patchy alopecia

Abstract

Neurodermatitis or Lichen simplex chronicus (LSC) is chronic skin disease in which emotional factors have a key role in the initiation of disease. A sixty year old lady presented with itcy lesion of scalp with localised area of loss of hair. After proper history taking and investigations she was diagnosed as LSC of scalp. She was treated with intralesional steroids,oral doxepin and psychotherapy. Complete remission of symptoms with total regrowth of hair occured in 3 months. The key role of emotional factors in causation of LSC and a proper psychotherapy along with dermatological treatment is necessary for complete cure of this condition.

Lichen simplex chronicus on the scalp: exuberant clinical, dermoscopic, and histopathological findings

“…A perivascular infiltration of lymphocytes and eventually macrophages is also commonly observed. 1 Histopathological features of the scalp lesion include preservation of follicle architecture, with a normal number of terminal follicles, but with a decrease in size and number of sebaceous glands. At the infundibulum level, the outer root sheath forms acanthotic jagged projections, termed "gear wheels."…”

“…Lichen simplex chronicus is a cutaneous disorder characterized by lichenification of the skin as a result of intense excoriation secondary to excessive primary pruritus, becoming a self-perpetuating mechanism. 1 , 2 It mostly affects female patients, with a peak incidence between ages 35 and 50 years. On the skin, it presents itself as a thickened and hyperpigmented lichenoid plaque.…”

“…It mainly affects the cervical region, ankles, scalp, vulva, scrotum, and extensor region of the upper limbs. 1 On the scalp, it manifests itself as a single or multiple oval lesions, with scaling, causing hair loss or breakage. 3 …”

Trichoteiromania: Good Response to Treatment with N-Acetylcysteine

“…Anecdotal reports also mention the use of topical capsaicin, tacrolimus, and doxepin hydrochloride. Psychotherapy is recommended as an adjuvant treatment [3, 18, 19]. …”

Cicatricial Alopecia with Particular Trichoscopic and Histopathological Features

“…It occurs as a result of constant scratching or rubbing of the skin and has been reported in the setting of other disorders such as atopic dermatitis, anxiety, or pruritus related to systemic disease [1, 2]. …”