Abstract
Lichen simplex chronicus is a chronic pruritic skin condition that significantly impacts quality of life. This retrospective study analysed 125 patients with clinically confirmed lichen simplex chronicus seen at a tertiary academic centre to characterize itch severity, anatomical distribution, and associated comorbidities. Itch intensity was assessed using the Numerical Rating Scale (NRS), and clinical data were stratified by demographics and disease extent. Most patients (75%) reported moderate-to-severe itch (NRS 4-10), with nearly 90% experiencing daily pruritus and half reporting both daytime and nocturnal symptoms. The limbs were the most commonly affected sites. Comorbid conditions were frequent, including generalized anxiety disorder (50% vs ~3% in the US adult population), major depressive disorder (44% vs ~8%), hypertension (61% vs ~45%), and type 2 diabetes (30% vs ~11%). Patients with multiple-lesion lichen simplex chronicus had significantly higher itch severity (mean NRS 7.81 vs 7.08, p = 0.001) and were more likely to be female (81% vs 46%, p = 0.002) compared with those with localized disease. These findings highlight the high symptom burden and frequent co-occurrence of psychiatric and metabolic comorbidities in lichen simplex chronicus. Thus, early identification and management of psychiatric, neurological, and metabolic conditions may improve outcomes for patients with lichen simplex chronicus.