Skin layers
Skin layers

Nummular eczema

Definition:
Nummular eczema is a hypersensitivity (allergy related) skin disorder causing characteristic itchy, coin-shaped lesions.

Alternative Names:
Eczema - nummular; Nummular dermatitis

Causes, incidence, and risk factors:
The cause of nummular eczema is unknown, but there usually is a personal or family history of asthma, allergies, atopic dermatitis, or similar disorders. It is a relatively uncommon disorder that most often occurs in elderly men.

Eczema is generally a chronic, recurring condition. Exposure to environmental irritants may worsen symptoms, as can dryness of the skin, temperature changes, and stress.
Symptoms:
Signs and tests:
Nummular eczema is diagnosed based on the appearance of the skin, and on personal and family history. A skin biopsy may sometimes be needed to exclude other conditions with a similar appearance.
Treatment:
The health care provider should be consulted for diagnosis of nummular eczema, as it can be difficult to differentiate from other skin disorders. Treatment should be guided by the health care provider.

Treatment is focused on relief of the symptoms. Anything that aggravates the symptoms is avoided whenever possible. Frequent bathing is not advised. Other possible allergens are avoided, including foods and environmental irritants, such as wool and lanolin.

Dry skin often makes the condition worse, so bathing and the use of soaps may be reduced. Temperature changes and stress may cause sweating and changes in the blood vessels of the skin, also aggravating the condition.

Topical treatment of weeping skin areas may include soothing lotions, soaps, or wet dressings. Mild antipruritic lotions or topical (applied to a localized area of the skin) steroids may be used to soothe scaly, dry, less acute, or healing areas. Chronic areas may be treated with ointments or creams that contain tar or corticosteroids, or lubricating, skin softening, or other ingredients. Systemic corticosteroids may (rarely) be used for severe cases.
Expectations (prognosis):
Nummular eczema is a chronic condition, but it may be controlled with treatment and avoidance of irritants.
Complications:
Possible complications are secondary infections of the skin.
Calling your health care provider:
Call for an appointment with your health care provider if symptoms indicate that you may have nummular eczema.

Call for an appointment with your health care provider if symptoms persist despite treatment and avoidance of allergens, or if signs of infection (such as fever, redness, or pain around a lesion) occur.
Prevention:
There is no known way to prevent the disorder. Avoiding environmental irritants and other aggravating factors may reduce the severity of symptoms in people who have nummular eczema.

Review Date: 11/4/2001
Reviewed By: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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