Nummular Eczema

Nummular eczema is also known as discoid eczema and is condition that causes a very itchy and easily recognized skin rash with coin shaped patches or lesions on the arms and legs (sometimes on the middle of the body) that ooze and may become crusty.  The skin may look scaly or raw with redness and inflammation.  Nummular eczema is more common in young adulthood and in old age, occuring more often in the fall and winter months rather than the rest of the year.

In most cases, discoid eczema does not run in families nor does it result from a food allergy.  It is not infectious to others although it can become infected by bacteria. There is both a wet and a dry nummular eczema.  Dry skin in the winter months can cause dry non-itchy round patches while the wet type presents as crusted or blistered patches.

There are many causes for nummular eczema and these include:

  • A reaction to topical irritants
  • A manifestation of winter dermatitis
  • A manifestation of atopic dermatitis in children
  • A complication from a staphylococcal infection
  • The result of a local physical or chemical injury
  • An allergy to aloe, hair removal creams, mercury and other irritants
  • The result of very dry skin
  • Excessive alcohol consumption
  • The result of prescription drugs
  • Extreme stress

 

Sometimes people will confuse this type of eczema with ring worm infections, psoriasis or regular eczema.

How can nummular eczema symptoms be treated?

  • By avoiding all irritants or triggers as much as possible.
  • By protecting all your skin carefully as this type of dermatitis often starts off as minor skin injuries.
  • By using gloves and tools (if the hands are affected) to make sure the skin is not irritated by friction, detergents, solvents, other chemicals or excessive water.
  • By placing wet compresses for 10 to 15 minutes on the rash in the early stages 3 times per day.
  • By using emollients.
  • By following your doctor or dermatologist's recommended treatment and medication.  They may suggest skin lotions or moist bandages to soothe scaly, dry or healing areas. If secondary bacterial infection is suspected, they will prescribe a course of antibiotics will clear the itchy skin rash faster. For thick patches, intralesional steroid injection is beneficial while tar ointments are useful in chronic dry discoid patches.  Phototherapy will be effective for recalcitrant nummular eczema.
  • By taking sedating antihistamines like hydroxyzine to help relieve the itching.
  • By avoiding triggers that can make your symptoms worse, such as wool, lanolin and certain foods.
  • By avoiding excess bathing and soaps that can cause dry skin and which often makes the condition worse.
  • By using a natural formula for treating eczema
  • By bed rest and removing yourself from a stressful environment in severe cases while at the same time taking supportive measures such as stress management.

 

Nummular dermatitis can usually be controlled with the above measures which should be continued for long after as the condition has a tendency to recur.  Make sure the skin is kept well moisturised, and protected from injury. Eventually, the eczema will clear up completely although in darker skins, marks may persist for some months.  These marks may be dark brown or paler than surrounding skin.



Further Reading: Dyshidrotic Eczema, Eczema Herpeticum

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