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Nummular eczema

Eczema - discoid; Nummular dermatitis

 

Nummular eczema is a dermatitis (eczema) in which itchy, coin-shaped spots or patches appear on the skin. The word nummular is Latin for "resembling coins."

Causes

 

The cause of nummular eczema is unknown. But there usually is a personal or family history of:

  • Allergies
  • Asthma
  • Atopic dermatitis

Things that can make the condition worse, include:

  • Dry skin
  • Environmental irritants
  • Stress
  • Temperature changes

 

Symptoms

 

Symptoms may include any of the following:

  • Coin-shaped skin lesions that are dry and scaly, and appear on the arms and legs
  • Lesions may spread to middle of body
  • Lesions may ooze and become crusty
  • Itching
  • Scaly or raw skin
  • Skin redness or inflammation

 

Exams and Tests

 

Your health care provider can usually diagnose this condition by looking at your skin and asking about your family's medical history.

A skin biopsy may be needed to rule out other similar conditions. Allergy testing may be done.

 

Treatment

 

Avoid triggers that can make your symptoms worse, such as wool, lanolin, and certain foods. Do not take frequent baths. Excess bathing and soap can cause dry skin, which often makes the condition worse. Also, avoid hot water while taking a bath or shower.

Your doctor may recommend skin lotion that repairs the barrier of the skin, special skin cleansers that are mild, or moist bandages to soothe scaly, dry, or healing areas. Antihistamines may be prescribed to relieve itching.

Persons with severe symptoms may be prescribed ointments that contain tar, corticosteroids, or other medicines that lower the immune system. In very severe cases, more powerful medicines called steroids are prescribed. These may need to be applied to the skin or taken by mouth.

 

Outlook (Prognosis)

 

Nummular eczema is a long-term (chronic) condition. Medical treatment and avoiding irritants can help reduce symptoms.

 

Possible Complications

 

A secondary infection of the skin may develop.

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of this condition.

Also call for an appointment if:

  • Symptoms continue despite treatment
  • You have signs of infection (such as fever, redness, or pain)

 

Prevention

 

There is no known way to prevent the disorder. Avoid any triggers that make your symptoms worse. Keep your skin moist and use gentle cleansers. Avoid things that irritate the skin.

 

 

References

Coulson I. Discoid eczema. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 59.

Reider N, Fritsch PO. Other eczematous eruptions. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 13.

 
  • Skin layers

    Skin layers - illustration

    The skin is the largest organ of the body. The skin and its derivatives (hair, nails, sweat and oil glands) make up the integumentary system. One of the main functions of the skin is protection. It protects the body from external factors such as bacteria, chemicals, and temperature. The skin contains secretions that can kill bacteria and the pigment melanin provides a chemical pigment defense against ultraviolet light that can damage skin cells. Another important function of the skin is body temperature regulation. When the skin is exposed to a cold temperature, the blood vessels in the dermis constrict. This allows the blood which is warm, to bypass the skin. The skin then becomes the temperature of the cold it is exposed to. Body heat is conserved since the blood vessels are not diverting heat to the skin anymore. Among its many functions the skin is an incredible organ always protecting the body from external agents.

    Skin layers

    illustration

    • Skin layers

      Skin layers - illustration

      The skin is the largest organ of the body. The skin and its derivatives (hair, nails, sweat and oil glands) make up the integumentary system. One of the main functions of the skin is protection. It protects the body from external factors such as bacteria, chemicals, and temperature. The skin contains secretions that can kill bacteria and the pigment melanin provides a chemical pigment defense against ultraviolet light that can damage skin cells. Another important function of the skin is body temperature regulation. When the skin is exposed to a cold temperature, the blood vessels in the dermis constrict. This allows the blood which is warm, to bypass the skin. The skin then becomes the temperature of the cold it is exposed to. Body heat is conserved since the blood vessels are not diverting heat to the skin anymore. Among its many functions the skin is an incredible organ always protecting the body from external agents.

      Skin layers

      illustration

    Self Care

     

      Tests for Nummular eczema

       

         

        Review Date: 4/14/2015

        Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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