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Lichenification is a change in appearance and texture of the skin associated particularly with pruritic dermatoses. Mild or early lichenification presents as a rather subtle coarsening of the skin surface markings on a background of dry and usually erythematous skin. As the condition progresses, the skin becomes markedly thickened and hyperkeratotic ( Fig. 23.32 ). The borderline between lichenification and some prurigos is tenuous, both in nomenclature and in practice. Prurigo nodularis could also be called nodular lichenification. Fig. 23.32 Lichenification of the arm in a patient with atopic eczema. The variable clinical severity of lichenification is reflected histologically in variable degrees of acanthosis and hyperkeratosis. Additional features specific to lichenified dermatoses are discussed further below. The features of lichenification are sometimes regarded as developing secondary to excoriation. This may not be entirely accurate, and it seems likely that inflammation associated with the underlying dermatosis often plays an independent role. Lichenification can occur to some degree in all pruritic, and especially eczematous, dermatoses. In lichen simplex, lichen striatus and notalgia paraesthetica, lichenification is usually the predominant clinical feature. Synonym • Circumscribed neurodermatitis Lichen simplex is an eczematous dermatosis characterized by a small ... log in or subscribe to read full text

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