Lichen Simplex Chronicus (LSC) is chronic dermatitis caused by repetitive scratching or rubbing of the skin. It presents as hyperpigmentation and thickening of the skin with variable scaling. Because LSC is a secondary lesion with a wide variety of causes, optimal management is contingent on identifying and managing its exact aetiology. We report an intriguing case of LSC in an elderly patient with longstanding scabies and sensory neuropathy.