Q: lichen simplex chronicus (neurodermatitis) for 10-11 years. I have large, raised, black, shiny lesions on both lower limbs. They itch a lot and screatching gives pleasure, but makes them progressively worse. I have tried corticosteroid creams (e.g., clobetasone); they provided some relief in the early days. I am using Dipsalic cream now. I do not have diabetes or hypertension. I have asthma which has required only oral salbutamol or terbutaline till now. What is the solution to my problem?

A:I appreciate your problem of lichen simplex chronicus. I call it Scratch dermatitis and do not like to use the term neurodermatitis- a commonly accepted term. The reason for my calling it Scratch dermatitis is amply borne out by your own statement- and that of several other patients - that scratching gives them relief and pleasure! Local application of steroids would help, but only temporarily. Unless you stop scratching there is no way you can get well. I think the solution to the problem lies in your fingers, not in the amount you wish to spend.