Lichen simplex (also known as Lichen Simplex Chronicus) is a severe form of eczema or dermatitis and is a very itchy condition which may affect just one area of the vulva although it can be more widespread and affect other areas such as the nape of the neck, the skin around the anus or the leg.

This type of eczema or dermatitis produces thickening of the skin which can be accompanied by splitting as well as bleeding, secondary to scratching.  The thickened skin itself is very itchy and further scratching or rubbing at the skin thickens the skin more.  The skin may appear very red, very pale or even very dark. 
Patient information

BAD web site eczema leaflet
http://www.bad.org.uk/site/796/default.aspx

National eczema society fact sheets - on seborrhoeic eczema and genital eczema
http://www.eczema.org/factsheets.html

Genital eczema and lichen simplex
http://www.dermnet.org.nz/site-age-specific/genital.html

Do I need any tests?

A biopsy may be helpful to confirm the diagnosis.
Blood tests to make sure you are not anaemic or short of iron may be done.
Testing for allergies to things in contact with your skin (Patch testing) may be necessary if allergic contact dermatitis is suspected.

Treatment

Lichen simplex is helped by a hygiene regime that does not irritate as harsh washing and cleansing of the vulva can make it more dry, irritated, sore and itchy.
For advice on caring for the vulval area:
Care Down There http://www.caredownthere.com.au/_pages/information_care.html
International Society for the Study of Vulvovaginal Disease
It is important to tackle the ‘itch-scratch-itch’ cycle of behaviour

Specific treatment

Treatment for this condition is the same as other types of dermatitis although a strong steroid cream or ointment may be needed initially to bring the thickness of the skin back down to normal.  After this time, the strength of the topical steroid can be reduced.  An sedating antihistamine by mouth can help sleep at night.

Stress for many patients can be a very important trigger in the development of lichen simplex chronicus.  This may require additional treatment and various lifestyle modifications to be made to ensure the condition fully resolves.    For other advice on treatment, please see the links below.

Genital eczema and lichen simplex
http://www.dermnet.org.nz/site-age-specific/genital.html