This skin disorder leads to a scratch-itch cycle:

• It may begin with something that rubs, irritates, or scratches the skin, such as clothing.
• This causes the person to rub or scratch the affected area. Constant scratching causes the skin to thicken.
• The thickened skin itches, causing more scratching, which causes more thickening.
• The skin may become leathery and brownish in the affected area.

Symptoms include:

• Itching of the skin
  • May be long-term (chronic)
  • May be intense
  • Increases with nervous tension, stress
• Skin lesion, patch, or plaque
  • Commonly located on the ankle, wrist, neck, rectum/anal area, forearms, thighs, lower leg, back of the knee, inner elbow
  • Exaggerated skin lines over the lesion
  • Distinct borders to the lesion
  • Becomes leathery in texture (lichenification)
  • Darkened (hyperpigmented) or reddened skin
  • Raw areas
  • Scratch marks
  • Scaling

The diagnosis is primarily based on the appearance of the skin and a history of chronic itching and scratching. A skin lesion biopsy may be needed to confirm the diagnosis.