FIGURE 65.3 Asteatotic eczema (Reprinted with permission from Goodheart HP Goodheart’s Photoguide of Common Skin Disorders 2nd ed Philadelphia, PA: Lippincott Williams & Wilkins; 2003.) Lichen Simplex Chronicus Lichen simplex chronicus refers to a chronic, localized lesion resulting from repeated rubbing and scratching It has a predilection for the sites that are easily reached, such as the arms, legs, ankles, neck, and the anogenital area It is rare in young children but fairly common in adolescents and adults It may occur in a pre-existing area affected by dermatitis Typical lesions are single or multiple oval plaques from to 15 cm in size The skin is reddened and slightly edematous Chronic lesions consist of welldemarcated areas of dry, thickened, scaly, hyperpigmented, or hypopigmented plaques, often with lichenification (accentuated skin markings) Intense pruritus is a hallmark While topical corticosteroids can be effective, some lesions may respond best to occlusion with a corticosteroid-impregnated tape or intralesional corticosteroid Monitoring