Lichen simplex chronicus and prurigo
Chapter 12:Diseases of the skin and subcutaneous tissue
ICD-10 L28 is a used to indicate a diagnosis of lichen simplex chronicus and prurigo.
Lichen simplex chronicus (LSC) and prurigo are chronic skin conditions characterized by intense itching and subsequent scratching, leading to thickened, leathery skin. LSC typically arises from a cycle of itch-scratch-itch, where repeated trauma to the skin results in hyperkeratosis and lichenification. The affected areas are often localized to regions that are easily accessible for scratching, such as the neck, scalp, and extremities. Prurigo, on the other hand, presents with papules that can be excoriated due to itching, often resulting in secondary infections. Both conditions can be exacerbated by stress, allergies, and other dermatological issues. Diagnosis is primarily clinical, based on the appearance of the skin and patient history, although a biopsy may be performed to rule out other conditions. Treatment focuses on breaking the itch-scratch cycle, utilizing topical corticosteroids, antihistamines, and in some cases, systemic medications. Education on skin care and avoidance of irritants is also crucial in managing these conditions.
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
L28 encompasses lichen simplex chronicus and prurigo, both of which involve chronic itching and scratching leading to skin changes. Diagnostic criteria include the presence of thickened skin in LSC and papular lesions in prurigo.
L28 should be used when the primary diagnosis is lichen simplex chronicus or prurigo, particularly when the clinical presentation includes significant lichenification or pruritic papules that are not better explained by other dermatitis codes.
Documentation should include a detailed patient history, clinical examination findings, treatment plans, and responses to therapy. Photographic evidence may also support the diagnosis.
