Lichen agrius

Lichen agrius, of the inflamed form of lichen, differs from the above in the presence of secretion, and hence approaches eczema; but it is, as its name implies, an acute, inflamed lichen. The local manifestation consists of clustered or closely packed red papulae, accompanied by intense itching and burning, causing the patient to scratch violently; this in its turn sets up additional irritation, the torn and excoriated papulae are inflamed, and exude a thin fluid; the whole patch thickens, fissures, and becomes covered over the thin scales, not the yellow puriform scales of eczema. Lichen agrius may also arise by inflammation of the chronic stage of any of the other forms of lichen, and not primarily as an acute form. The acute state lasts about ten or fifteen days, the chronic weeks or months; this variety of lichen is observed about the back, neck, legs, arms, and shoulders; it constitutes one aspect of grocers', bricklayers', and balers' itch. Vesicles and pustules may, however, form; and then there is an inflamed, raised, red­dened, excoriated, discharging, fissured patch, the seat of intense and often intolerable itching and burning, made worse by stimulation of all kinds, especially the warmth of bed. The disease either subsides or increases by the development of fresh crops of papulae.