Arch Dermatol Res. 2025 Jan 15;317(1):249. doi: 10.1007/s00403-024-03775-7.
ABSTRACT
The use of antidepressant medications in the treatment of lichen simplex chronicus (LSC) also known as neurodermatitis, is not well-documented in the literature. The primary aim of our study is to evaluate the impact of duloxetine 30 mg on the quality of life in patients with LSC, focusing on both pruritus and psychopathological aspects. The secondary aim is to investigate the relationship between LSC and anxiety and depression. The observational prospective clinical study, conducted from November 2023 to November 2024, included male and female patients aged 18 and older diagnosed with neurodermatitis (lichen simplex chronicus). Inclusion criteria required a confirmed diagnosis by a dermatologist. Exclusion criteria included other skin conditions, polyneuropathies (e.g., diabetic, chemotherapy-induced), malignancy, current use of antidepressants or neuropathic pain medications, and medications known to cause itching (e.g., β-blockers, ACE inhibitors, antacids). Patients with LSC at the dermatology clinic were assessed by a dermatologist using the DLQI and a neurologist using the Beck Depression and Anxiety Inventory before and after three months of treatment. The study included 219 patients with a mean age of 39.6 (12.2) years, 69.5% female and 30.5% male. Post-treatment, the Duloxetine 30 mg + 0.05% alpha clobetasol propionate group showed the most significant improvement in DLQI scores (p < 0.05). This group also had a notable reduction in itchiness scores by the third month, with more change over time. The greatest reduction in scores on the Beck Depression Inventory-II and Beck Anxiety Inventory was observed in the Duloxetine 30 mg + 0.05% alpha-clobetasol propionate group, with this reduction continuing in a decreasing pattern in the Duloxetine 30 mg and 0.05% alpha-clobetasol propionate groups, respectively. Significant changes in the time-group interaction were observed only in the Duloxetine 30 mg + 0.05% alpha-clobetasol propionate and Duloxetine 30 mg groups (p < 0.05). No significant time effect was seen in the 0.05% alpha clobetasol propionate group. In the regression analysis, both BAI and BDI-II showed significant and strong effects on DLQI (p < 0.05). Our study suggests that duloxetine 30 mg may be effective in treating LSC by reducing pruritus and addressing comorbid psychiatric conditions like anxiety and depression. The multidisciplinary approach, involving both dermatological and neuropsychiatric evaluations, is essential for treatment. Long-term, multicenter studies are needed to confirm these findings.
PMID:39812844 | DOI:10.1007/s00403-024-03775-7
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