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Lichen simplex chronicus is a form of chronic localized pruritus with a secondary dermatitis, and one of the most common types of chronic itch conditions, estimated to affect more than 10% of the general population. However, despite its prevalence and burden, there has been limited research into the pathogenesis and aetiology of lichen simplex chronicus, which, historically, made it a challenging condition to treat. In recent years, our understanding of this condition, along with that of pruritus and the itch-scratch cycle, has increased greatly, enabling a substantial increase in treatment options. In addition, there are several new promising treatments currently in development and trials. This article discusses the definition, epidemiology, clinical characteristics, pathophysiology, and current therapeutic options for lichen simplex chronicus, in order to highlight recent advancements in this field.

Scalp dysaesthesia, considered a variant of the cutaneous dysaesthesia syndrome, is characterized by chronic sensory symptoms, including pruritus, pain, burning and stinging in a well-defined location, without objective findings. Its aetiology is not well elucidated and treatment options are limited, thus it can be challenging and frustrating for both patient and physician. It can be associated with lichen simplex chronicus. In this paper, we review the literature on the pathogenetic factors, diagnostic methods and therapeutic options in the management of scalp dysaesthesia. Dissociation, cervical spine disease and muscle tension seem to be the most important pathogenetic factors. Trichoscopy, reflectance confocal microscopy and biopsy are all helpful for the diagnosis of the disease. Therapies include high-potency topical or intralesional corticosteroids, capsaicin and topical anaesthetics, sedative antihistamines, tricyclic antidepressants, transcutaneous electric nerve stimulation, botulinum toxin and vitamin B12., (© 2021 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)

The authors reviewed outpatients in a tertiary dermatology clinic in Botswana to expand knowledge on patterns of skin disease in this population with a high prevalence of human immunodeficiency virus (HIV). Approximately one-third of new and follow-up patients were HIV positive. Common dermatologic conditions included eczematous eruptions, viral and fungal infections, malignant neoplasms, vascular disorders, disorders of pigmentation, and mechanical/physical injury-related disorders. HIV has impacted patterns of dermatologic disease in Botswana, with Kaposi sarcoma being the most frequently biopsied condition. Given the shortage of dermatology specialists, resources should be allocated toward education and management of these most prevalent skin conditions., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To compare the efficacy and safety of the treatment of vulvar lichen simplex chronicus (VLSC) using high-intensity focused ultrasound (HIFU) at different powers., Methods: This retrospective study included 152 patients with VLSC. Among these patients, 70 were treated with HIFU at low power (level 2), and 82 were treated at normal power (level 3). The treatment responses, recurrence rates and intra- and postoperative complications were all compared., Results: No statistically significant differences were found between the two groups in age, disease course, menopause status, lesion size and severity of symptoms. All patients received one session of HIFU therapy, and the treatment process was successful. No difference was found in the total response rate between the two groups at 1 (85.7% versus 87.8%, p  = .35), 6 (80% versus 80.5%, p  = .65) and 12 (80% versus 80.5%, p  = .73) months after HIFU therapy. No significant difference was observed in the recurrence rate between the two groups at 6 (5.7% versus 9.8%, p  = .36) and 12 (22.9% versus 26.8%, p  = .57) months after HIFU treatment. Patients in the low-power group had a lower incidence of blisters (10% versus 23.3%, p  = .04)., Conclusion: Based on our results, low-power HIFU treatment can achieve a therapeutic effect similar to normal power HFU treatment for VLSC, but its incidence of side effects is lower.

Common benign chronic vulvar conditions include genitourinary syndrome of menopause (formerly called vulvovaginal atrophy), lichen sclerosus, lichen planus, lichen simplex chronicus, and vulvodynia. Genitourinary syndrome of menopause results from the hypoestrogenic state that leads to atrophy of normal vulvar and vaginal tissues. It is typically treated with lubricants, moisturizers, and intravaginal estrogen. Lichen sclerosus is an inflammatory condition characterized by intense vulvar itching. It is treated with topical steroids or, in some cases, topical calcineurin inhibitors. Patients with lichen sclerosus are at risk of vulvar squamous cell carcinoma and should be monitored closely for malignancy. Lichen planus is an inflammatory autoimmune disorder that can affect the vulva and vagina in addition to other skin and mucosal surfaces. The first-line treatment is topical steroids, and significant scarring can occur if left untreated. Lichen simplex chronicus manifests as persistent itching and scratching of the vulvar skin that leads to thickened epithelium. Breaking the itch-scratch cycle, often with topical steroids, is the key to treatment. Vulvodynia is a common vulvar pain disorder and is a diagnosis of exclusion. A multimodal treatment approach typically includes vulvar hygiene, physical therapy, psychosocial interventions, and antineuropathy medications.

Background: Neurodermatitis is a common inflammatory and allergic disease, characterized by itching and lichenification plaque. Some studies have reported cupping therapy (CT) for the treatment of neurodermatitis. However, the effectiveness and safety are still uncertain. This study aims to evaluate the efficacy and safety of CT for the treatment of patients with neurodermatitis., Methods: We will retrieve the following electronic databases systematically: Pubmed, Web of Science, Embase, the Cochrane Library, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, and Wanfang database from their inception to December 2020. Other literature resources will be manually searched. Published randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) on the topic will be retrieved by 2 investigators independently. We will apply a fixed-effect model or random effect model basis on the heterogeneity test and employ with RevMan 5.3 software for data synthesis. The total clinical effective rate will be selected as the primary outcome, skin disease quality of life index score, recurrence rate, and adverse events as secondary outcomes., Results: This study will comprehensively summarize the high-quality trials to determine the efficacy and safety of CT for the treatment of patients with neurodermatitis., Conclusion: Our systematic review will present evidence for the efficacy and safety of CT to neurodermatitis patients., Osf Registration Number: DOI 10.17605/OSF.IO/6DCM3.

The purpose of this study was to investigate the therapeutic effects of focused ultrasound on the expression of notch1, c-fos and transforming growth factor-β3 (TGF-β3) in genital skin of SD rats with vulvar lichen simplex chronicus (LSC). Fifty-six female SD rats with LSC were randomly divided into therapy and sham groups. The therapy group was exposed to focused ultrasound. The sham group received the same therapy with an instrument that had no power output. Four wk after a singly focused ultrasound therapy, histologic analyses revealed that recovered SD rats accounted for 75% of SD rats in the therapy group and 10.7% in the sham group. Total collagen fiber density in the superficial layer of dermis in the therapy group was significantly lower than that in the sham group. Notch1 and c-fos protein expression in the therapy group was significantly lower than that in the sham group, with the opposite effect present for TGF-β3. Focused ultrasound therapy may inhibit superficial collagen fibrosis in the dermis by affecting expression of notch1, c-fos and TGF-β3 in vulvar skin tissue and consequently reduce the recurrence rate of LSC., Competing Interests: Conflict of interest disclosure The authors declare no competing interests., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Atopic dermatitis (AD) represents a chronic inflammatory skin disease showing a 1-year prevalence of 2-3% during adulthood. In a national randomized, controlled multicenter study initiated by the "Arbeitsgemeinschaft Neurodermitisschulung im Erwachsenenalter" (ARNE, Working Group on Educational Training for Adults with Atopic Dermatitis) a program for structured patient education conducted by a multiprofessional team was developed and evaluated. At 1‑year follow-up, coping behavior with respect to itch (assessed by the "Juckreiz-Kognitions-Fragebogen", p < 0.001) and in quality of life (Skindex-29, p < 0.001) significantly improved in patients who had participated in this 12 h patient educational program (n = 168) compared to the waiting control group (n = 147). Moreover, the training led to a significantly greater reduction in disease severity (SCORAD Index, p < 0.001). In this first randomized, controlled multicenter study on effects of patient education in adulthood AD, significant beneficial effects on both psychosocial parameters and the disease severity could be demonstrated.

Vulvar pruritus and lichen simplex chronicus are common reasons for presentation to women's health practitioners, including gynecologists and dermatologists. Both conditions are multifactorial and are often confounded by other inflammatory, neoplastic, infectious, environmental, neuropathic, hormonal, and behavioral variables. Careful history taking and thorough physical examinations, including wet mount and potentially skin biopsy, are necessary for appropriate diagnosis. Treatment should focus on decreasing inflammation, reducing irritants, and providing symptomatic relief to achieve remission. Comprehensive treatment covering environmental, biological, and behavioral therapy can result in long-term cure for patients with these conditions., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Introduction: Chronic scratching is common to many skin disorders. Being a female and presenting a high level of psychopathology are risk factors for chronic scratching. Yet, it is unclear why. Certain personality characteristics that are more prevalent in women are also known to influence emotional states (i.e. emotional tension)., Objective: The present study aims to explore whether these personality styles might help understand why gender and emotional distress are associated with scratching., Material and Methods: We compared the personality patterns of 103 patients (69.9% women) diagnosed with Lichen Simplex Chronicus, against a sample of healthy individuals., Results: Significant differences were found in the personality styles of men and women with LSC. Women were more pessimistic, oriented to fulfil the needs of others, traditional, insecure, submissive, and reserved, with moderate (d=.43) to strong (d=.96) size effects ranges. Some of these differences, such as in traditionalism, dutifulness, other-orientation, and pessimism, were also observed when compared with healthy men and women, with small (d=.03) to moderate (d=.47) size effects ranges., Conclusions: These psychological factors may help explain the mechanisms underlying gender differences in chronic scratching, at least in Lichen Simplex Chronicus. The findings might open new avenues for research and treatment., (Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Inflammatory vulvar dermatoses affect many women, but are likely underdiagnosed due to embarrassment and reluctance to visit a health care provider. Although itch and pain are common presenting symptoms, the physical examination can help distinguish between different disease entities. Because many women's health providers have minimal training in the categorization and management of dermatologic disease, definitive diagnosis and management can be difficult. Herein, strategies for diagnosing vulvar lichen sclerosus, lichen planus, contact dermatitis, lichen simplex chronicus, and psoriasis are discussed along with basic management of these diseases, which commonly involves decreasing inflammation through behavioral change, gentle skin care, topical corticosteroids, and systemic therapies.

Objective: Avoiding potentially irritating contact is a key point in vulvar lichen simplex chronicus (VLSC) management. This study aims to assess the use of nonirritating silk fabric underwear (Dermasilk) as an adjuvant tool in the treatment of VLSC., Methods: Twenty women with VLSC were enrolled in a 1-week open-label active treatment phase with topical 0.1% mometasone furoate (MMF) ointment. Participants then entered a 4-week double-blind maintenance phase (MP) in which they were randomized to wear either silk fabric or cotton briefs. During MP, participants were allowed to use MMF on an "as-needed" basis. The main efficacy endpoints were to assess and compare the two intervention groups on the following: (1) number of participants who needed to apply MMF throughout MP; (2) mean number of MMF applications; (3) mean symptom-free interval before MMF reapplication; and (4) changes in the severity of symptoms and signs., Results: During MP, four women in the silk fabric briefs group applied MMF compared with six women in the cotton briefs group (relative risk, 0.66). The mean number of MMF applications was lower in the silk fabric briefs group than in the cotton briefs group (P = 0.074). VLSC symptom-free interval was 22.5 days in the silk fabric briefs group and 7.2 days in the cotton briefs group (P = 0.0003). At the end of MP, symptom improvement determined after corticosteroid use increased in the silk fabric briefs group but worsened in the cotton briefs group., Conclusions: Silk fabric underwear may be a useful tool for the management of VLSC by diminishing external sources of irritation and may reduce use of corticosteroids.

Vulvar pruritus can be caused by a wide spectrum of diseases, that depend on age, environmental and genetic factors. The most common causes are candidiasis, contact dermatitis and lichen simplex chronicus. Candidiasis is the most common cause of acute vulvar pruritus and is characterized by burning, itching and vaginal whitish secretion. Contact dermatitis is caused by irritants or allergens that are in contact with the genital area, which causes imbalance in the skin barrier causing irritation, swelling, burning, among other manifestations. Lichen simplex chronicus is characterized by lichenification (thickening of the skin) secondary to the chronic itch-scratch cycle in vulvar area. It is an illnes with a tendency to chronicity, but with topical corticosteroids treatment usually might be controlled. Prompt treatment, multidisciplinary and careful attention to irritants and secondary infections prevent these entities become an important and permanent problem.

Background: Localized itch of non-pruritoceptive origin is often neuropathic and may be referred to as neuropathic itch syndrome., Objectives: To describe the results of nerve conduction studies in patients with anogenital pruritus, brachioradial pruritus and scalp dysesthesia, and compare these sites to typical sites of lichen simplex chronicus (LSC)., Methods: The study summarizes previously published data combined with unpublished data of patients with scalp dysesthesia. Nerve conduction studies included measurements of distal sensory and motor latency, conduction velocity and F-responses., Results: A neuropathy was demonstrated in 29 of 36 patients with anogenital pruritus (80.5%), 8/14 with brachioradial pruritus (57.1%) and 4/9 with scalp dysesthesia (44.4%). The typical sites overlapped with some but not all LSC sites., Conclusions: A considerable proportion of patients with brachioradial pruritus, anogenital pruritus and scalp dysesthesia have abnormal nerve conduction findings, suggesting a neuropathic origin. The skin sites overlap with some common LSC sites, suggesting that in some cases of LSC a local neuropathy could be a possible cause.

The assessment of the health state in patients and changes in their health state for the purpose of diagnosis, prognosis and monitoring of treatment response plays a central role in clinical practice. Quality criteria for measurements in medicine include validity, reliability, responsiveness, interpretability, and feasibility. High-quality measurement instruments are a prerequisite for evidence-based medicine. Therefore, international outcomes research groups have developed methods for quality assurance and for the standardisation of measurement instruments. Quality indicators are instruments to measure the quality of care. Due to the increasing relevance of quality assessment for all stakeholders in healthcare and due to the political intention to draw relevant conclusions from the assessment of the quality of care, quality indicators must at least meet the same high standards that are required for clinical trial end points. However, independent researchers and clinicians do not engage in the validation and standardisation of quality indicators in Germany; currently, only the AQUA institute (as assigned by the German GBA) deals with this important issue. Current activities concerning the validation of quality indicators do not meet the requirements of evidence-based healthcare. This is a critical barrier to achieving the political goals of quality medicine. Therefore, the authors propose a multi-step, multi-professional, evidence-driven and evidence-generating consensus process on the basis of established methods of outcomes research for the advancement of quality assessment with quality indicators in Germany. All relevant stakeholders should participate in this process., (Copyright © 2013. Published by Elsevier GmbH.)

Lichen sclerosus, lichen planus, and lichen simplex chronicus are dermatologic conditions that can affect the vulva. Symptoms include vulvar itching, irritation, burning, and pain, which may be chronic or recurrent and can lead to significant physical discomfort and emotional distress that can affect mood and sexual relationships. With symptoms similar to common vaginal infections, women often seek care from gynecological providers and may be treated for vaginal infections without relief. Recognition and treatment of these vulvar conditions is important for symptom relief, sexual function, prevention of progressive vulvar scarring, and to provide surveillance for associated vulvar cancer. This article reviews these conditions including signs and symptoms, the process of evaluation, treatment, and follow-up, with attention to education and guidelines for vulvar care and hygiene., (© 2012 by the American College of Nurse-Midwives.)

Vulvar pruritus is a common and distressing condition for patients, and its presentation is often delayed and complicated by home remedies. The true prevalence cannot be accurately estimated. Vulvar pruritus is a symptom, and an underlying cause must be sought and not assumed. This is best accomplished by obtaining a careful history of vulvar care regimens and treatments, performing a detailed physical examination, and considering a broad differential diagnosis. This article provides a practical and clinical approach to the evaluation of vulvar pruritus and then focuses specifically on one common cause, lichen simplex chronicus., (Published by Elsevier Inc.)

To reduce pruritus and colonization with Staphylococcus aureus, textiles containing silver are increasingly used as therapeutic option for patients with atopic dermatitis (AD). While wearing such textiles, the contained silver is in close contact with the patient's skin. The silver serves two purposes: to reduce bacterial colonization of the skin, and to prevent contamination of the textile with ensuing growth of microorganisms. It is unknown whether the silver impregnation is able to reduce bacterial contamination of the textile during wearing and to prevent bacterial growth within the textile. The aim of this study was to investigate the bacterial contamination in textiles containing silver versus placebo worn by patients with AD and to determine the efficacy of processing worn textiles by manual and machine-based washing. Additionally, the effect of silver textiles on S. aureus and total bacterial counts colonizing the skin of AD patients was analyzed. The reduction factor of silver textile compared to placebo was 0.5 log steps against S. aureus and 0.4 log steps against total bacteria. Silver textiles exhibited significantly less S. aureus as well as total bacterial colonization after 2 days of wearing without washing, as compared with a placebo textile. On placebo textiles 385.6 +/- 63.5 CFU total bacteria and 236.5 +/- 49.9 CFU S. aureus, and on silver textiles 279.9 +/- 78.7 CFU total bacteria and 119.3 +/- 39.4 CFU S. aureus were found on the inner side of the textiles facing the neurodermitis lesions. However, the unexpectedly high residual contamination despite the silver exposure represents a potential risk as recontamination source of S. aureus that could maintain the proinflammatory process in AD. This contamination is nearly completely eliminated by machine-based washing at 60 degrees C using conventional washing powder. AD patients wearing silver textiles should change their used clothes at least daily and wash them in a washing machine at 60 degrees C., ((c) 2009 S. Karger AG, Basel.)

Lichen simplex chronicus (LSC) of the anal region is characterized by massive pruritus, constant itching and a chronic course. Histology is notable for a pseudoepitheliomatous hyperplasia. Correct diagnosis as well as therapy of anal LSC sometimes is difficult. Differential diagnostic considerations include verrucous lichen planus and squamous cell carcinoma. We present three cases and then summarize pathogenesis, diagnostics, differential diagnoses and therapeutic options for lichen simplex chronicus of the anal region.

Background: Transcutaneous electrical nerve stimulation (TENS) has recently emerged as a possible effective treatment for pruritic dermatoses. Lichen simplex (LS) is one such condition, which may persist despite intensive topical treatments., Aim: To investigate the efficacy of TENS treatment in relieving pruritus in lichen simplex., Methods: In total, 22 patients with LS unresponsive to topical corticosteroids underwent TENS treatment. The patients rated the pruritus intensity on a visual analogue scale (VAS)., Results: The mean reduction in VAS score from baseline to the end of 4 weeks treatment was 4.50 (95% CI 3.65-5.34) for all patients. The difference between the baseline and at the end of the study was significant (P < 0.01). By the end of the study, 18 (80%) of the subjects experienced a reduction in pruritus intensity of > 50%., Conclusion: From our clinical observation, we suggest that TENS may prove to be a useful and well-tolerated treatment modality for the treatment of pruritus in patients with LS.

Lichen sclerosus, lichen planus, and lichen simplex chronicus are three of the most common non-neoplastic epithelial disorders of the vulva. Lichen sclerosus is characterized by intense vulvar itching and can affect men and women of all ages, but it manifests most commonly in postmenopausal women. Patients with lichen sclerosus have an increased risk of developing squamous cell carcinoma, and they should be monitored for malignancy. Lichen planus is an inflammatory autoimmune disorder that can affect the vulva and the vagina; it peaks in incidence between ages 30 and 60. There are three clinical variants of lichen planus affecting the vulva: erosive, papulosquamous, and hypertrophic. Lichen simplex chronicus is caused by persistent itching and scratching of the vulvar skin, which results in a thickened, leathery appearance. It is thought to be an atopic disorder in many cases and may arise in normal skin as a result of psychological stress or environmental factors. Definitive diagnosis of non-neoplastic disorders depends on the histology of biopsied tissue. All three disorders are treated with topical corticosteroid ointments of varying potency. Lichen sclerosus and lichen planus are not routinely treated with surgery, which is necessary only in patients who have a malignancy or advanced scarring that causes dyspareunia or clitoral phimosis. Educational counseling teaches patients that even though these chronic disorders cannot be cured, they can be effectively managed.

Emotional tensions in predisposed subjects may play a key role in inducing a pruritic sensation, leading to a scratching that, becoming a self-perpetuating pathomechanism, may represent the main feature of two distinct cutaneous clinical entities: prurigo nodularis and lichen simplex chronicus. Psychogenic factors play a relevant role in both conditions, and they are often associated with depression and dissociative experiences. Hence, the importance of the evaluation of these patients from the point of view of psychodermatology, which may analyze the relationship between skin disease and psychological factors. Patients with real or perceived imperfections in particular areas of the body (face, scalp, hands, and genital area) are more prone to psychologic distress, whereas cutaneous diseases may lead to experience a heightened level of distress. As psychosomatic factors have been estimated to be present in at least one-third of dermatologic patients, effective management of skin conditions involves consideration of the associated emotional factors.

Objective: To search for an effective therapy for neurodermatitis., Methods: Ninety-six cases were divided into 2 groups by random number table. The treatment group (n = 54) were treated by hot-red needle therapy combined with blood-letting puncturing and cupping at skin-injured area, and the control group (n = 42) were treated with external smearing of halometasone cream., Results: The cured rate and the total effective rate were 51.9% and 96.3% in the treatment group, and 28.6% and 81.0% in the control group, respectively, with a significant difference between the two groups in the therapeutic effect (P < 0.05)., Conclusion: Red-hot needle therapy combined with blood-letting puncture and cupping has a definite therapeutic effect on neurodermatitis, without toxic and adverse effects.

Objective: To compare the difference of the therapeutic effects between Yang's cotton moxibustion and hormonotherapy on neurodermatitis., Methods: Sixty cases of neurodermatitis were divided into a treatment group and a control group according to random number table. The treatment group were treated with Yang's cotton moxibustion and the control group with triamcinolone and urea cream. After treatment for one week, the therapeutic effect was start to be observed. After the treatment was given for 4 weeks, the therapeutic effect was evaluated., Results: The total effective rate was 93.3% in the treatment group and 80.0% in the control group, with a significant difference between the two groups (P < 0.05)., Conclusion: Yang's cotton moxibustion has an obvious therapeutic effect on neurodermatitis with a good safety.

A modern skin care concept involving physiological lipids should be matched to the state of the skin, the season of the year and the presence of dermatoses. Also desirable would be substances that regulate the moisture status and barrier function of the stratum corneum, e.g. glycerin, in relevant concentrations. Of central importance in diseases associated with destruction of the uppermost layer of the skin, for example, neurodermatitis, is regular skin care with moisturizing products and a lipid composition that is as physiological as possible. In addition, the water and lipoid content of the skin care formulation should be matched to disease stage and the season of the year.

Objective: To observe the therapeutic effects of plum-blossom needle tapping combined with the modified yangxue dingfeng tang (a decoction for nourishing the blood and expelling wind) for the localized neurodermatitis., Methods: 141 cases of the localized neurodermatitis were randomly divided into 3 groups. Forty-seven patients in the treatment group received local tapping and oral medication of the modified yangxue dingfeng tang which consisted of sheng di huang ([Chinese characters: see text] Radix Rehmanniae), dang gui ([Chinese characters: see text] Radix Angelicae Sinensis), chi shao ([Chinese characters: see text] Radix Paeoniae Rubra), tian dong ([Chinese characters: see text] Radix Asparagi), mai dong ([Chinese characters: see text] Radix Ophiopogonis), jiang can ([Chinese characters: see text] Bombyx Batryticatus), mu dan pi ([Chinese characters: see text] Cortex Moutan), chuan xiong ([Chinese characters: see text] Rhizoma Chuanxiong), he shou wu ([Chinese characters: see text] Radix Polygoni Multiflori), and quan xie ([Chinese characters: see text] Scorpio). Forty-seven patients in the control group I were simply given the modified yangxue dingfeng tang; and 47 patients in the control group II were treated with oral benadryl and Vitamin C plus local external application of 10% urea ointment. The treatment course for all the 3 groups lasted 30 days., Results: The short-term and long-term effects for the treatment group were much better than those of the 2 control groups (P < 0.05)., Conclusion: The plum-blossom needle tapping plus the modified yangxue dingfeng tang exhibits a better and stable effect for the localized neurodermatitis.

Background: The intimate relationship of the skin and the mind illustrates the importance of a holistic approach in caring for patients with skin problems. Habits related to psychological problems may lead to skin problems such as lichen simplex chronicus and acne excoriée. Emotional stress may affect skin diseases such as atopic dermatitis, perioral dermatitis, pompholyx, and plaque psoriasis., Objective: This article describes the relationship between the mind and skin disease., Discussion: Skin disease can exert a profound effect on the psychosocial dimension of a patient's life. Its effect on quality of life can be objectively assessed and documented by validated tools specific for the skin. Patient rated measures should be taken into account when evaluating the efficacy and adverse effects of treatments for skin disease.

Squamous cell conjunctival carcinomas (SCCC) are rare. We report on a 34-year-old patient with neurodermatitis and chronic conjunctivitis who presented with a therapy-resistant corneal ulcer induced by mechanical irritation diagnosed as SCCC. Chronic blepharoconjunctivitis seems to sustain the development of SCCC in patients with neurodermatitis because of their insufficient immune response.

In a busy dermatologic practice, it may be frustrating to encounter a vulvar disease patient, who must fully disrobe for examination. Further, the wet mounts, cultures, biopsies, and patient education required for treatment of vulvar disorders take up considerable time. However, most patients will respond to appropriate therapy, and can be very gratifying to treat.

Many neuropsychiatric diseases present with concomitant dermatologic manifestations. These manifestations may help the clinician formulate a correct diagnosis when it is otherwise unclear. In this article, we present six cases with clinical photographs of associated skin findings discussed from a neuropsychiatrist's perspective. Each case will be followed by a discussion and a brief review of the associated neuropsychiatric and dermatologic aspects of the disease.

Lichen simplex chronicus (LSC) of the anogenital area is an eczematous disease characterized by unremitting itching and scratching. In most instances, it arises in individuals who are genetically atopic, and as such, LSC can be viewed as a localized variant of atopic/neurodermatitis. Common triggers for the development of the disease include psychological distress, and local environmental problems such as heat, sweating, and excess dryness. Lichen simplex chronicus may also develop as a superimposed condition in the presence of other anogenital diseases such as candidiasis, psoriasis, lichen sclerosus, tinea cruris, and neoplasia. Lichen simplex chronicus frequently persists as an itch-scratch cycle, even when environmental triggers are removed and the underlying disease is treated. For this reason, successful therapy requires attention not only to trigger factors, but also to repair of the damaged barrier layer, reduction in inflammation, and breakup of the itch-scratch cycle.

Atopic dermatitis is a chronic-relapsing disease that often requires an individualized therapeutic approach. There are various treatment options that address known pathogenetic pathways and, when used in combination, are often very successfull. In view of the fact that a unifying pathogenic concept as well as a therapeutic regimen is not available to this very day, preventative measures that should be introduced in very early childhood. Therefore, one very important goal in treatment is to identify and eliminate triggering factors which include irritants, allergens and cutaneous bacterial, viral or fungial infections. The mainstay of therapy today are external emmollients, which when used appropriately, can reduce the need for systemic treatments. The reconvalescence can be speeded up by auxilliary therapies such as UVA or UVB, psychotherapeutical strategies such as stress reduction as well as so-called climate-("Klima") therapy.