Do I have Lichen simplex chronicus?

Q: I have a skin problem. I think it is Lichen simplex chronicus (LSC) based on what I have read on your website. The itching starts in the evening and becomes worse by night. Its all over around my testicles and extends towards the anus. I also get itching on the folds behind my ears when I sweat. The skin around my testicles has become dark and rough and becomes red on scratching. I used to apply Canstat-B (clotrimazole & betamethasone dipropionate) and it helped a lot, but I had to use it regularly. Now, the composition of Canstat-B has changed to clotrimazole beclomethasone dipropionate, which does not give any good results. I have been advised to avoid touching or scratching but its very hard to resist. Can I get rid of this problem permanently? I am 35 years old.

A:It appears you have seborrhoeic dermatitis as the primary problem. LSC, if you have, is the secondary change, which has resulted from repeated and continual scratching. Topical steroids are the mainstay for treating lichenified lesions. However, one must try to control seborrhoeic dermatitis by non-steroidal medicines. These include ketoconazole, metronidazole, etc. The selection will depend upon the severity and extent of the disease and presence of other comorbid conditions. Once controlled, maintenance therapy may be required and the use of steroids may then become only occasional.