How Is Discoid Eczema Treated
A number of medications are available from your doctor to help treat discoid eczema, and there are also things you can do at home to make the skin more comfortable. See your GP for a diagnosis if you think that you may have discoid eczema, because other skin conditions such as psoriasis and ringworm can look very similar.
Related Conditions And Causes Of Nummular Eczema
- Dry skin caused by cold, dry weather
- Sensitive skin
Eczema often starts in childhood. If your child has eczema, use the American Academy of Pediatrics handy Symptom Checker to understand the signs, triggers, and treatment for this condition, plus information on when to call the pediatrician and photos to help with identification.
Nummular Eczema And Cancer
Nummular eczema can look like psoriasis, ringworm, fungal infection and other types of eczema, including atopic dermatitis, stasis dermatitis and contact dermatitis. It can also occur along with those types of eczema, though it often appears as an isolated condition. Dermatologists can usually spot the condition but may take a skin scraping to confirm a diagnosis. Once correctly.
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When Should I See A Doctor
If nummular eczema is not treated, the rash will continue to get worse. It can be very itchy and sometimes nummular dermatitis causes pain or bleeding when you touch the affected area of skin. Nummular eczema may also cause your inflamed skin to peel or look like a burn because of excessive scratching. Untreated nummular eczema rashes can also lead to a secondary infection like a bacterial infection. Please see your healthcare provider or dermatologist if you believe you are suffering from nummular eczema.
Enhancing Healthcare Team Outcomes
Inflammatory dermatoses such as nummular dermatitis are often treated by primary care physicians, nurse practitioners, physician assistants, or dermatologists. Although the differential diagnosis of nummular dermatitis is quite broad, it is most often clinically diagnosed by recognizing its patterns of morphology, distribution, and epidemiology. Ancillary testing such as skin scraping with potassium hydroxide preparation, bacterial swab for culture and sensitivities, or biopsy may be performed either in the primary care or dermatologic setting. If the nummular dermatitis is unresponsive to conservative management and topical corticosteroids, it is appropriate to consult a dermatologist. A specialist should supervise patch testing, narrowband UVB treatment, or systemic immunosuppressant, or immunomodulatory therapy.
Treatment of nummular dermatitis can be optimized with an interprofessional team approach. The patients nurse, primary care provider, or dermatologist should monitor for therapy compliance, report any adverse effects, and relay the response to therapy to the remainder of the team. This type of interprofessional teamwork will enhance patient outcomes and minimize adverse reactions in caring for patients with nummular dermatitis.
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Symptoms Of Discoid Eczema
Discoid eczema causes distinctive circular or oval patches of eczema. It can affect any part of the body, although it does not usually affect the face or scalp.
The first sign of discoid eczema is usually a group of small spots or bumps on the skin. These then quickly join up to form larger patches that can range from a few millimetres to several centimetres in size.
On lighter skin these patches will be pink or red. On darker skin these patches can be a dark brown or they can be paler than the skin around them.
Initially, these patches are often swollen, blistered and ooze fluid. They also tend to be very itchy, particularly at night.
Over time, the patches may become dry, crusty, cracked and flaky. The centre of the patch also sometimes clears, leaving a ring of discoloured skin that can be mistaken for ringworm.
You may just have 1 patch of discoid eczema, but most people get several patches. The skin between the patches is often dry.
Patches of discoid eczema can sometimes become infected. Signs of an infection can include:
- the patches oozing a lot of fluid
- a yellow crust developing over the patches
- the skin around the patches becoming hot, swollen and tender or painful
- feeling sick
- feeling unwell
What Are The Clinical Features Of Discoid Eczema
Discoid eczema usually affects the limbs, particularly the legs, but the rash may be widespread. Although often bilateral, the distribution can be asymmetrical especially if related to varicose veins.
There are two clinical forms of discoid eczema:
- Exudative acute discoid eczema: oozy papules, blisters, and plaques
- Dry discoid eczema: subacute or chronic erythematous, dry plaques
Individual plaques are well circumscribed, mostly 13 cm in diameter, and inflamed. The majority of patches are round or oval. The plaques are usually very itchy. The skin between the patches is usually dry and irritable.
Severe discoid eczema may generalise, with numerous small to large itchy plaques appearing all over the body due to an autoeczematisation reaction.
Patches may clear up without leaving a sign. In dark skin, marks may persist for months as dark brown postinflammatoryhyperpigmentation or pale postinflammatory hypopigmentation.
Exudative discoid eczema
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Nummular Eczema: Triggers Symptoms & Treatment
Nummular eczema is a common type of eczema. It is different than the usual eczema and can be much more difficult to treat.
Those suffering from nummular eczema develop circular-shaped spots on their skin, which become very itchy. Due to its fungal like appearance it can often appear to look like ring worm. The cause of nummular eczema is unknown, however researchers suspect it could be genetic.
Many people, even those who have severe nummular eczema seem to clear up completely and do not appear to have the long-term issues like other forms of eczema.
Symptoms of nummular eczema include
- Round, coin-shaped spots
It is thought to be triggered by things like:
- Insect bites
- Dry skin in the colder months
What can you do to help control Neurodermatitis?
Like atopic dermatitis, nummular eczema benefits from moisturisers to calm and protect the damaged skin barrier.
Doctors may prescribe:
- In cases where steroids are not appropriate, your doctor may prescribe a non-corticosteroid topical medication
- Topical or oral antibiotics
How To Use It
People can buy aloe vera gel in health stores or online, or they can purchase an aloe vera plant and use the gel directly from its leaves.
Individuals should aim to use aloe gel products with few ingredients others can contain preservatives, alcohol, fragrances, and colors, which can irritate sensitive skin. Additionally, alcohol and other drying ingredients could make eczema worse.
However, start with a small amount of gel to check for skin sensitivity, as sometimes, aloe vera can cause burning or stinging. However, it is generally safe and effective for adults and children.
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Causes And Risk Factors Of Nummular Eczema
If you have sensitive skin, you may also develop NE if you dont take care. NE is triggered by factors that cause dry skin, says Friedler. If you have a history of skin reactions or eczema, be wary of taking long, hot showers, using harsh or strongly scented soaps, and allowing your skin to become too dry. You may also notice flare-ups during winter, when the air outside is cold and dry and the forced heat indoors is dry, too, notes Friedler.
How To Get Rid Of Nummular Eczema
The main goals of nummular eczema treatment are to clear up your skin and relieve your discomfort. To do this, your treatment plan may include a treatment designed to:
1- Avoid irritating your sensitive skin:
Dry, sensitive skin is more likely to experience frequent flare-ups of nummular eczema. For this reason, your treatment plan may include instructions that can help you prevent skin irritation. It is important to wash your skin regularly at all stages of nummular eczema, as cleansing helps prevent infection of your now fragile skin.
You may need to use only a mild, non-drying cleanser to wash your skin, and apply it only to the skin that needs to be washed. Gentle cleansers and eczema cleansers are recommended because they are less drying and less irritating to eczema-prone skin.
Got all that? With this information in mind, here are several candidates for the best cleansers for eczema-prone skin.
A-Derma Exomega Control Emollient Shower Oil
Ducray Dexyane Ultra-Rich Cleansing Gel
Eau Thermale Avene XeraCalm A.D Lipid-Replenishing Cleansing Oil
2- Hydrate your skin:
You likely have extremely dry skin. To add moisture to your skin, and help it heal, you may need to:
Your dermatologist may suggest a hypoallergenic, unscented moisturizing cream or ointment instead of a lotion. Creams and ointments hold water in the skin better than lotions. More water in the skin can help you heal faster. Please note that moisturizers should not be applied on eczema lesions.
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Gentle Soaps And Detergents
Laundry detergent can contain harsh chemicals that aggravate eczema.
Many body washes and cleansers contain detergents, which help provide a soapy lather. Detergents and other lathering agents can dry out the skin, especially in people with eczema.
Bar soaps can also be harsh on the skin because of their alkalinity.
Try using a gentle, no-lather, fragrance-free cleanser. Avoid products with rough particles for scrubbing or exfoliating, as these can further irritate the skin.
Many people with eczema also find that switching to a more gentle, fragrance- or color-free laundry detergent can help improve symptoms.
Additionally, try skipping fabric softener, which lingers on clothes and often contains fragrances and chemicals that can irritate the skin.
Sitting next to a fireplace or near a furnace may feel good, but it can worsen eczema symptoms. The hot, dry air can dehydrate the skin and aggravate the itchiness of eczema.
Use a humidifier during the dry winter months and avoid getting too close to heaters and fireplaces.
If You Continue To Have Flare
Its common for nummular eczema to come and go. If you have spots and patches on your skin or the itch feels unbearable, a board-certified dermatologist can help.
ReferencesCenters for Disease Control and Prevention. Alcohol use and your health. Page last reviewed October 1, 2020. Last accessed December 11, 2020.
Jiamton S, Tangjaturonrusamee C, et al. Clinical features and aggravating factors in nummular eczema in Thais. Asian Pac J Allergy Immunol. 2013 31:36-42.
Leung AKC, Lam JM, et al. Nummular eczema: An updated review. Recent Pat Inflamm Allergy Drug Discov. 2020 Aug 10. .
Miller JL, Nummular dermatitis . In James WD . Medscape. Last updated November 2020.
Purnamawati S, Indrastuti N, et al. The role of moisturizers in addressing various kinds of dermatitis: A review. Clin Med Res. 2017 15:75-87.
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What Is The Treatment Of Discoid Eczema
As discoid eczema is associated with loss of skin barrier function, it is important to:
Protect the skin from injury.This type of dermatitis often starts after minor skin injuries, so careful skin protection is required. If the hands are affected, use gloves and tools to make sure the skin is not irritated by friction, detergents, solvents, other chemicals, or excessive water.
Apply emollients frequentlyEmollients include bath oils, soap substitutes and moisturising creams. They can be applied to dermatitis as frequently as required to relieve itching, scaling, and dryness. Emollients should also be used on the unaffected skin to reduce dryness. It may be necessary to try several different products to find one that suits. Many people find one or more of the following helpful: glycerine and cetomacrogol cream, white soft paraffin/liquid paraffin mixed, fatty cream, wool fat lotions, or urea cream.
Avoid allergens
If patch testing has identified contact allergy, exposure to the allergen should be avoided.
Anti-inflammatory treatments include:
Topical steroidsTopical steroids are anti-inflammatory creams or ointments available on prescription to apply just to the patches once or twice daily for 24 weeks. Topical steroids reduce symptoms and clear the dermatitis.
AntibioticsAntibiotics are often prescribed if the dermatitis is blistered, sticky, or crusted. Sometimes discoid eczema clears completely on oral antibiotics, only to recur when they are discontinued.
Getting The Right Diagnosis
Itâs important to see a dermatologist to find out for sure whatâs causing your symptoms. Nummular eczema can look like several other common skin conditions, including:
- A fungal infection
- Another type of eczema
Dermatologists are skin experts. Yours might be able to identify nummular eczema just by looking at it. Or, to be certain, the doctor might scrape off a little skin and send it to a lab for analysis.
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Nummular Eczema Vs Ringworm
As they progress, nummular eczema lesions can resemble another condition caused by the ringworm fungus.
Ringworm also tends to present itchy bumps that turn into round, itchy, and scaly patches with a clear center. They may look red or pink on lighter skin, or brown and gray on darker skin. Both types of lesions will be very itchy. Ringworm lesions tend to heal from the center first.
A dermatologist is a specialist trained in knowing the difference between these two conditions, and other conditions, like psoriasis, that have similar presentations.
What Is Nummular Eczema Symptoms Causes Diagnosis Treatment And Prevention
Are you noticing circular, rough, red patches on your arms, hands, or legs? Do they itch like crazy? You may have a flare-up of nummular eczema , a subtype of chronic eczema thats characterized by extremely itchy round or oval spots on the skin.
is a manifestation of sensitive skin that is triggered by environmental factors, and it can also happen in almost anyone who practices poor skin care, says Suzanne Friedler, MD, a board-certified dermatologist with Advanced Dermatology in New York City. NE can also occur in patients who regularly moisturize and practice good skin care, but whose skin lacks the proteins needed to lock moisture into the skin .
To understand what NE is, exactly, look closely at the words. Nummular means coin-like and eczema is sensitive skin. Therefore, people with NE display coin-shaped, itchy red patches on their skin, Dr. Friedler says.
Although this condition is treatable, it can be incredibly uncomfortable because of the itch, and may return even after treatment.
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How To Get Rid Of Nummular Eczema: Do Your Best
Because its a chronic condition, youll likely never get rid of nummular eczema completely. However, if you take some lifestyle approaches focused on lowering inflammation, you may be able to at least manage the frequency and severity of symptoms. Doing this can also help treatment in the long run, making doctor-prescribed treatment more effective.
The less you have to rely on corticosteroid treatment, the less likely you are to build a tolerance or be subject to uncomfortable or dangerous side effects.
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What Does Discoid Eczema Look Like
Another name for discoid eczema is nummular dermatitis, which means coin-shaped eczema. It usually appears quite suddenly on the first occasion, when one or two round or oval dull red patches appear, the size of a 50 pence piece or smaller. These patches start off with a slightly bumpy surface and fuzzy edges, usually on the lower legs, trunk or forearms, although hands and fingers can also be affected. Within a few days the patches often develop raised lumps or blisters which start to ooze, and they can become very itchy, crusted and infected. Later on, the surface becomes scaly and the centres of the discs clear, leaving the skin dry and flaky. At any time between 10 days and a few months later, other discs may appear, often in the same position on the opposite side of the body other patches may then come up in different places, such as on limbs previously not affected. Old patches that have apparently cleared up may also reappear.
With treatment, the condition can be improved in many cases, although discoid eczema does tend to recur and may leave pale areas and dark areas in patients with darkly pigmented skin. Usually, the skin returns to a perfectly normal appearance after several months, and scarring is very rare.
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Research On Nummular Eczema Diet
When it comes to nummular eczema specifically, a 2021 study showed that a gluten-free diet may help you manage the symptoms of the condition.
In this case, an 11-year-old girl was able to remain completely symptom-free while avoiding all gluten. However, more research is needed to confirm whether this is true beyond this single case.
A 2020 study also showed there may be some benefit to L-His supplementation . This is a supplement containing the amino acid histidine, which the body metabolizes into histamine.
Histamine is an amino acid involved with growth and immunity. The research shows it may improve the symptoms of severe nummular eczema that is resistant to other treatments.
The following conditions may increase your risk of developing nummular eczema, according to the AAD:
- living in a cold, dry climate
- dry skin
What Is Nummular Eczema
Nummular eczema is a type of eczema characterised by coin shaped spots on the skin. The spots are usually really itchy, and they can be moist and ooze fluids, or dry and rough.
Medical science has yet to find the definite cause of this skin disease. There is no firm conclusion as to what causes nummular eczema, but there is some speculation that nummular eczema is a lot more frequent for people that have had allergies, atopic dermatitis, or history with asthma.
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How Do Dermatologists Diagnose Nummular Eczema
When you have nummular eczema, a dermatologist can often diagnose you by examining the spots or patches on your skin.
Dermatologist examining spots on a patients hand
When diagnosing a skin condition, dermatologists rely on their in-depth knowledge of the skin and tools that magnify their view.
If your skin shows signs of infection, your dermatologist will swab that spot.
Your dermatologist may also perform a skin biopsy. This involves removing a bit of the affected skin to test it for a condition. Your dermatologist can perform a skin biopsy during your office visit.
If you have nummular eczema, your dermatologist will create a treatment plan tailored to your needs.