Lichen Simplex Cronicus

I have had Psoraisis (psoriasis) since I was 12 and it went away when I was about 53. I am 68 and last year developed Lichen Simplex Cronicus on my buttocks. I used Triamcinolone,.5% and after a week it went away. This year it came back in May. The dermatologist gave me a shot and by early July it went away but in about 10 days came back. I was using Lidex, 2 times a day since and now today,the Doctor gave me a shot of Kenalog. I read where there is long term effects of both Lidex and kenalog. Is there some other choice? Is this condition food related by any chance? What causes it and what can be done? Thanks for your help.

[Bhupinder Kaur, MD]

Hello,
Lichen Simplex Chronicus is seen in people with eczema. It is non contagious. It is treated like chronic eczema by decreasing water and soap contact, and applying emollients. Topical steroids are almost always needed to control the symptoms. You can use mild steroid cream like Dermacort and if the symptoms persist then high potency steroids and oral steroids may be needed.
My sincere advice would be to consult a dermatologist to get the diagnosis confirmed. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[gunbb]

I have seen a dermatologist. I started with Triamcinolone .5% which worked for awhile but then he prescribed Lidex which was fine as long as I used it 3 times a day and stood or layed down,not sit.Now he gave me a shot of Kenalog which is a steriod. I read that these steroids have a long term effect.. I still have the itching and try to ignore it. MY QUESTION IS >>>>>> Is there something else that can be done or am I screwed?? IS IT FOOD/ALLERGY RELATED?? Thanks, BB

[Bhupinder Kaur, MD]

Hello,
Lichen simplex chronicus is found on the skin in regions accessible to scratching. Pruritus provokes rubbing that produces clinical lesions, but the underlying pathophysiology is unknown. But a role of sensitization and contact dermatitis in the etiology of lichen simplex chronicus has been proposed.

Oral antianxiety medications and sedation may be considered in certain patients. You can also use doxepin cream  and capsaicin cream after consulting your doctor.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[gunbb]

What are the effects of Kenalog? He wants to give me a booster every month.I see that Kenalog is a Cortisone product and it says that use reduces your immune system and also can cause diabetes amoung other complications.I see where JFK got daily shots of Cortisone for his back problems. Mine are once a month. Is there still a problem with this shot of Kenalog, once a month? Thanks, BB