Lichen simplex chronicus (LSC) is manifested by gradual thickening of the skin associated with constant rubbing. Lichenification means the thickened skin has enhanced skin markings resulting from the friction of excessive itching and rubbing. This skin finding can be associated with atopic dermatitis. Many times the itching is of an unknown cause. Individual thickened and persistent papules may be observed (prurigo nodularis) but are less common in children than adults. LSC is most common in older individuals.