Lower Extremity Venous Ablation as a Treatment Modality for Refractory Lichen Simplex Chronicus and Generalized Pruritus

Abstract

Introduction: Lichen simplex chronicus (LSC) is a skin condition characterized by thick, leathery, scaly and extremely itchy patches of skin. It is a common pathology (up to 12% of population) with signifi cant effect on quality of life without any established clear etiology or treatment. Chronic venous insuffi ciency (CVI) is a progressive disease of the legs that occurs when the delicate bicuspid valves in the veins become weakened and develop refl ux. CVI has been associated with many complications including local or generalized pruritus that may lead to intractable itch-scratch cycle, leading to LSC lesions on various parts of the body. Cases: Recent development of multiple in-offi ce ablation techniques for treatment of CVI have led to the added benefi t of resolving the itch-scratch cycle, which in turn become the cure for LSC lesions. We present 6 cases with typical refractory LSC lesions whom we were able to cure after treatment of CVI using Radiofrequency ablation or Clarivein techniques. Conclusion: We recommend all primary care physicians and dermatologists to consider an underlying CVI as a potential cause for any LSC lesions or even intractable pruritus.