Scalp dysesthesia and lichen simplex chronicus: diagnostic and therapeutic update with literature review.

Abstract

Scalp dysesthesia and lichen simplex chronicus, conditions that can be associated, are both challenging and frustrating for the patient and the physician. The etiology is not well elucidated and treatment options are limited. Pathogenetic factors, diagnostic methods and therapeutic options in the management of scalp dysesthesia are reviewed according to the literature: dissociation, cervical spine disease and muscle tension seem to be the most important pathogenetic factors. Trichoscopy, reflectance confocal microscopy and biopsy are all relevant for the diagnosis of the disease. Therapeutic approach includes high-potency topical or intralesional corticosteroids, capsaicin and topical anesthetics, sedative antihistamines, tricyclic antidepressants, transcutaneous electric nerve stimulation, botulinum toxin and vitamin B12.