Patients with neurodermatitis experience a vicious cycle. Their lesions may start with a small irritation to the area, and the patient begins to scratch the itchy area. This constant scratching causes the skin to thicken, and this thickened skin itches which causes more scratching and greater thickening. In this way, patients find relief from scratching the inflamed site and continued subconscious scratching may lead to the recurring eruption [1, 2, 5].

Solak et al. also found that damage to the peripheral nervous system played a role in the etiology of neurodermatitis on the limbs, finding that nerve root compression and radiculopathy were more common in patients with neurodermatitis. As such, these patients should be examined for a possible underlying neuropathy [3].

A patient normally presents with chronic itching of the skin which increases in times of stress. The skin may appear as a lichenified, dark patch or plaque commonly located in easy to reach areas of the body. The skin may also appear raw with fresh scratch marks and scaling [1, 5].

The diagnosis of neurodermatitis is based on a patient’s history of itching and scratching and examination of their skin. A physician may biopsy the affected site to rule out other pruritic conditions [2].

The primary goal of treatment is to break the itch-scratch cycle. Physicians may prescribe corticosteroids (Clobetasol) or anti-histamines to relieve the pruritus. Additionally, nodules caused by picking at the scalp may require intralesional injections with triamcinolone acetonide.