ABSTRACT
Anogenital lichen simplex chronicus (LSC) is a chronic, itching and extremely uncomfortable disorder characterized by lichenification, with varying degrees of excoriations caused by scratching and rubbing. Upregulation of some major histocompatibility complex molecules and increased skin infiltration of Langerhans and T cells seem to predispose to LSC and its chronic course. Patients with anogenital LSC report intense and intractable pruritus that may disturb sleep, disrupt social life, work life, and sex life. Due to disruption of the normal skin barrier, impetiginization can occur. The main differential diagnoses include candidiasis, psoriasis, tinea cruris, contact dermatitis, and lichen sclerosus. The diagnosis of LSC is usually based on patient history and physical examination, but a skin biopsy can aid in equivocal cases. In genital psoriasis dotted vessels are regularly distributed over a pale red, pinkish background and eczematous lesions, especially in acute forms, show dotted vessels distributed in a patchy pattern, together with yellow crusts, which correspond to spongiotic process and exudation.
