Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Nummular Eczema?
This is a puzzling dermatological condition that have at least two other names beside this common name. The other two names it is known by include:
- A longer and more medically descriptive name – nummular eczematous (dermatitis)
- A name that is derived from the disease’s typical lesions that are coin-shaped – discoid eczema (dermatitis)
All forms of eczema are collectively known as atopic dermatitis. Men between the ages of fifty-five and sixty-five are more likely to be affected by this condition but anyone can get this medical condition. When a woman has nummular eczema it usually happens between the ages of fifteen and twenty-five. It is rare to see this medical condition in children but if it is seen in children it could be that there was a change in lotions, soaps, or detergent or taking a new medication. It is said that two out of every one thousand people in the United States has this skin disorder
Anyone who has this condition is also vulnerable to other forms of dermatitis also. In nummular eczema the lesions that are associated with this condition will often involve a ring formation that has a clear center causing it to sometimes being misdiagnosed as ringworm, which is a fungal infection. Nummular eczema will usually affect the lower legs but can also involve your arms, hands, and torso.
The progression between individuals with nummular eczema varies greatly. One person may suffer from only one or two lesions for just a few weeks but others may have multiple lesions that can last for years. In anyone who has had nummular eczema can have a reoccurrence. It is not contagious.
Nummular Eczema Symptoms
The most common symptom of nummular eczema is the itchy coin-shaped lesions. They are observed as itchy patches that are well defined and can be very large or small in diameter with sizes ranging from two to ten centimeters. The can be pink, red, or brown in color and either numerous patches or a single patch. When they first start out they are usually small papules. In times these patches will form a ring that has a center clear. There are times that they ooze and become crusty in appearance and then turn into brown macules. With the older lesions they can be scaly.
Some other symptoms might include:
- Burning sensation
- Inflamed skin
- Raw skin
Causes of Nummular Eczema
The exact cause for nummular eczema is not known but it seems that there is a link between dry skin and nummular eczema. There have been also been different suggestions as to what could be causing this medical conditions. These suggestions, or causative factors, may singly or in some combination forms cause this medical condition. Some of these suggestions include:
- Dry skin
- Using some prescription medicines such as isotretinoin
- Bacterial infections that cause hypersensitivity reactions in your skin.
They have ruled out allergy, fungal, and genetic causes. There are certain conditions in which nummular eczema may be worsened by or cause a flare-up which can include:
- Dry weather
- Dry skin conditions
- Wearing tight clothes may out of wool
- Excessive usage if detergents and soaps
- Frequent hot baths
- Using topical medications
- Excessive intake of caffeine
- Extreme climatic conditions
- Some type of allergies but at this time they are not sure which ones.
Nummular eczema is generally diagnosed by the simple observation of the physical appearance of your skin. Your physician may ask your medical history and your family’s medical history. To rule out the presence of other similar skin disorders the physician may have a skin biopsy taken. They will take a sample of the affected spots and then look at it under a microscope. Doing a skin biopsy can also help rule out any type of cancerous skin conditions.
There is no set treatment for nummular eczema so any treatments that are used are to treat the symptoms. Some of the treatments used can include:
You can help improve itching and redness with applying moisturizers. Using moisturizing lotions or creams can help prevent your skin from becoming dry. When applying moisturizers make sure that it is a thick kind and apply it over your dry, scaly patches to help moisten the areas along with providing relief from the itchiness.
Using topical or oral medication may also help to reduce the discomfort caused by nummular eczema. Your physician may prescribe penicillin antibiotics as part of the treatment if there are signs of infection in the blisters that are fluid filled. If they start to ooze you may be given oral penicillin called Flucloxacillin.
In some cases patients that are complaining of itchy skin may be given antihistamines that are taken by mouth can give some relief from the itchiness. If you are suffering from hypersensitive immunity, using antihistamines can help to control the immune responses.
For acute cases corticosteroids such as prednisone may be given through injection or orally for seven to fourteen days until the symptoms are under control. The physician may follow this treatment with topical lotions and creams to keep the condition under control.
It may also be recommended that to help reduce the scales and dryness and help heal the spots you may be given moist bandages, soaps, and skin lotions.
It is also recommended that you avoid any irritants that you know cause breakouts of nummular eczema like clothes that are not comfortable against your skin, taking hot showers too often, using soaps that dry out your skin, etc.