心理治疗
生物反馈和催眠这些心理疗法已被用于治疗 LSC 并取得了积极的成效。[43]Shenefelt PD. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind? Dermatol Ther. 2003;16:114-122.http://www.ncbi.nlm.nih.gov/pubmed/12919113?tool=bestpractice.com[44]Rosenbaum MS, Ayllon T. The behavioral treatment of neurodermatitis through habit-reversal. Behav Res Ther. 1981;19:313-318.http://www.ncbi.nlm.nih.gov/pubmed/7271697?tool=bestpractice.com[45]Lehman RE. Brief hypnotherapy of neurodermatitis: a case with 4-year followup. Am J Clin Hypn. 1978;21:48-51.http://www.ncbi.nlm.nih.gov/pubmed/696664?tool=bestpractice.com
肉毒杆菌毒素
研究显示,在 LSC 局限区域皮内注射 20 个单位的 A 型肉毒杆菌毒素这种单一疗法,可使瘙痒在 3-7 天内消退,并且可在 2-4 周内消除这些 LSC 病损。[54]Heckmann M, Heyer G, Brunner B, et al. Botulinum toxin type A injection in the treatment of lichen simplex: an open pilot study. J Am Acad Dermatol. 2002;46:617-619.http://www.ncbi.nlm.nih.gov/pubmed/11907521?tool=bestpractice.com根据推测,这一效应的作用机理是肉毒杆菌毒素阻滞乙酰胆碱(特应性皮炎中的一种瘙痒介质)。使用肉毒杆菌毒素治疗 LSC 未获 FDA 批准。
针灸和电针疗法
针灸和电针疗法(将低压、高频电刺激施加到针灸针)已用于治疗 LSC 并可通过减少发炎皮肤中的促炎神经肽发挥作用。[55]Yang Q. Acupuncture treatment of 139 cases of neurodermatitis. J Tradit Chin Med. 1997;17:57-58.http://www.ncbi.nlm.nih.gov/pubmed/10437249?tool=bestpractice.com[56]Liu JX. Treatment of 86 cases of local neurodermatitis by electro-acupuncture (with needles inserted around diseased areas). J Tradit Chin Med. 1987;7:67.http://www.ncbi.nlm.nih.gov/pubmed/3497316?tool=bestpractice.com
酮替芬
这是一种肥大细胞稳定剂,已成功用于治疗儿童 LSC,但会导致嗜睡和头晕等潜在不良反应。[57]Kikindjanin V, Vukaviic T, Stevanocvic V. Effectiveness of ketotifen in the treatment of neurodermatitis in childhood. Dermatol Monatsschr. 1990;176;741-744.http://www.ncbi.nlm.nih.gov/pubmed/2128829?tool=bestpractice.com
加巴喷丁
在一份病例报告中,使用加巴喷丁进行治疗,最初 300 mg/天,后逐渐增加至 900 mg/天,持续 4-10 个月,可使 LSC 全部或至少部分缓解。[58]Gencoglan G, Inanir I, Gunduz K. Therapeutic hotline: treatment of prurigo
nodularis and lichen simplex chronicus with gabapentin. Dermatol Ther. 2010;23:194-198.http://www.ncbi.nlm.nih.gov/pubmed/20415827?tool=bestpractice.com