The early symptoms of neurodermatitis primarily manifest as small, flat polygonal papules the size of pinpoints or rice grains on the skin of the neck, sacral area, elbows, inner thighs, perineum, and around the anus. These can appear red, light red, or light brown and are relatively hard in texture. The surface may have a small amount of coagulated blood. Due to episodic severe itching, a vicious cycle of itching, scratching, more itching, and more scratching occurs during the course of the disease, which can lead to the merging of rashes into large patches.