Nummular Eczema

What is nummular eczema?

Also known as nummular dermatitis or discoid eczema, nummular (which means coin shaped) eczema is a chronic & recurring form of eczema characterized by disk shaped patches on the skin.

The cause isn’t known although it has been suggested that the condition may be triggered by a local trauma such as an insect bite or abrasion, irritants or chemicals. It can also occur alongside atopic eczema.

People of any age can be affected, although is seen more commonly in older people, especially men & tends to affect those with very dry skin. Secondary bacterial infection can occur in some patients.

Nummular eczema is not contagious to others. It is not an inherited condition.

Symptoms of nummular eczema:

• One or more well defined, itchy, disk shaped, red lesions usually found on the arms & legs. The surface of the lesions may be scaly or contain tiny blisters which may ooze & then form a crust.
• Secondary bacterial infection may occur.

Treatment for nummular eczema:

There is no cure for nummular eczema. Keeping the skin well moisturized is important & treatment is similar to that of atopic eczema, which includes;

• Emollients: Bathing in lukewarm water & replacing soap with emollients (moisturising creams, ointments). Avoid the use of perfumed moisturisers as these may aggravate the situation.
• When drying after a bath, pat dry, don't rub the skin.
• Topical steroids: During an outbreak, topical steroid ointments. It is generally recommended to use the lowest strength possible & apply only on affected areas. Long term side effects of topical steroid ointments include thinning of the skin. These should be applied immediately after your bath.
• Systemic steroids: Either in tablet form or injections. These may be prescribed for severe cases or cases that fail to respond to topical steroid creams.
• Oral antihistamines may be necessary during an outbreak to reduce the itch.
• If the skin becomes infected, your doctor may prescribe antibiotics.
• Ultraviolet therapy: This is known as phototherapy & uses an ultraviolet light. Either ultraviolet A (UVA) or ultraviolet B (UVB). In severe cases, a substance called psoralen is applied prior to phototherapy. Psoralens make the skin more sensitive to UV light. This is known as PUVA (psoralens plus ultraviolet A). Ultraviolet exposure does increase the risk of skin cancer.
• Topical immunomodulators (TIMS). These are relatively new drugs on the market. They suppress the immune system in the affected area. It may be recommended in cases that have failed to respond to other types of therapy, or in areas of the body where skin is thin, such as the face or groin.
• Use a humidifier in dry environments such as homes with central heating.

While great care has been made in the creation of these articles, we cannot guarantee the accuracy or omissions on these pages. If in any doubt whatsoever, seek professional medical advice.