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Journal Compilation © 2020 Acta Dermato-Venereologica. doi: 10.2340/00015555-3390 Lichen simplex chronicus (LSC) is a skin disorder characterized by lichenification of the skin as a result of primary excessive scratching (1). Clinically, leukoderma foci are often observed in chronic long-term lesions of LSC. Pruritus is a predominant symptom in LSC. A relationship has been suggested between neural tissue and inflammatory mediators in the perception of itch, which subsequently leads to LSC (2). The concept of a neuroimmune connection, in which close interactions between the nervous and immune systems regulate peripheral inflammation and link psychosocial stress with chronic disease, is now becoming accepted (3). Meanwhile, peripheral nerves have been shown to significantly influence melanocytes and melanogenesis. Both melanocytes and nerve fibres are derived from the neural crest. Nerve growth factor (NGF) is implicated in melanocyte survival, migration and dendricity (4). The number and distribution of nerve fibres, including those that secrete neuropeptides, are altered in lesional skin in vitiligo (5). The mechanism of leukodermatous alteration in LSC remains unclear. Since pruritus is sometimes provoked by peripheral nerve fibres, and since melanocytes are maintained by NGF, we have focused on nerve fibres as the critical factor connecting pruritus and leukoderma appearing in LSC lesions. In the context of a neuroimmune connection, this study compared melanocytes and peripheral nerves in leukoderma areas with those in nonleukoderma areas in LSC.

An Intimate Relationship Between Intralesional Depigmentation and Peripheral Nervous System in Lichen Simplex Chronicus