The effect of topically applied aspirin on localized circumscribed neurodermatitis.
BACKGROUND
Lichen simplex chronicus is a troublesome intractable itchy dermatosis, which may persist despite intensive topical treatments. Recently it has been demonstrated that topical aspirin solution with dichloromethane has a significant antipruritic effect in an experimentally induced itch.


OBJECTIVE
The aim of this double-blind, crossover placebo trial was to evaluate the efficacy of this solution in the treatment of lichen simplex chronicus.


METHODS
Twenty-nine patients with lichen simplex chronicus of at least 3 months' duration that did not respond to topical corticosteroids were randomized in a double-blind fashion to receive aspirin/dichloromethane solution in treatment period 1 for 2 weeks followed by placebo in treatment period 2 or placebo followed by aspirin in period 2 with a crossover design after a 2-week washout. The patients rated the pruritus intensity before and during therapy with a visual analog scale; a blinded investigator performed photographic assessment.


RESULTS
A significant therapeutic response was achieved in 11 (46%) of the patients who completed the study compared with 3 patients (12%) receiving placebo. Overall, aspirin-treated patients experienced an average decrease in the visual analog scale of 2.18 +/- 2.86 versus 0.69 +/- 2.31 of those receiving placebo. The difference between the 2 treatments for week 2 was significant (P =.03).


CONCLUSIONS
The study suggests that topical aspirin/dichloromethane might be a practical treatment for lichen simplex chronicus.
Yosipovitch
G
G
National Skin Center, National Medical Research Council, Ministry of Health, Singapore.
Sugeng
M W
MW
Chan
Y H
YH
Goon
A
A
Ngim
S
S
Goh
C L
CL
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008752:Methylene Chloride / Q000008:administration & dosage; D008875:Middle Aged; D009450:Neurodermatitis / Q000188:drug therapy*; D012996:Solutions; D016896:Treatment Outcome
D012996:Solutions; D008752:Methylene Chloride; D001241:Aspirin