Nummular Dermatitis

What is Nummular Dermatitis?

Nummular Dermatitis refers to a rare skin condition where the skin develops coin-shaped or oval lesions in patches.  This is also called nummular eczema or discoid eczema. These patches often last for weeks or even months.

Nummular Dermatitis is not contagious. It is more commonly found in men than in women. However, when it occurs in men, it happens later on in life usually, between the ages of 55 and 60. When women get it, it usually occurs at a younger age during their teens and early adulthood.

Symptoms of Nummular Dermatitis

The skin condition is characterized by:

• The appearance of coin-shaped or oval lesions.
• It starts out as a patch of tiny, reddish bumps on the skin and then enlarge and grow together to form a coin-shaped patch.
• Each patch will be between 1-4 inches in size.
• The patches can be itchy. The severity of the itching sensation can range from moderate to severe.
• The patches can be brown, pink or red in color.
• They may contain clear fluid or be dry and crusty.
• They may develop on arms and legs usually but can spread to the torso also.
• Sometimes there may be a burning sensation.
• The skin around the lesions may be inflamed or scaly and can be reddish or normal in color.
• In case of bacterial infection, the patch may be yellow in color and crusty in nature.

Causes of Nummular Dermatitis

The exact cause of Nummular Dermatitis is unknown as of yet. It does not run in families so it may not be genetically transferred. The causes have been linked to the following points:

• The patches often appear after a skin injury has happened either through a burn, an insect bite or some abrasion caused by friction.
• It is common in people who have a family history of skin conditions like allergies or other forms of dermatitis such as atopic and stasis dermatitis.
• Usually, people who have sensitive skin can develop this condition as their skin gets irritated easily and often gets inflamed.
• Those with dry skin, especially those who live in cold weather conditions can also develop it.
• Stress can also be an aggravator for the patches.
• Exposure to certain environmental agents can trigger the onset of the patches. These agents are usually found in harsh soaps, certain cosmetics, mercury from dental fillings and formaldehyde.
• Certain medications taken to treat other skin conditions can also add to the problem.

Diagnosis of Nummular Dermatitis

If these circular lesions are becoming evident on the skin, it is important to get them checked out by a doctor. The doctor will make a note of the medical history of the patient first and then carry out a visual inspection.

A skin biopsy will be done to rule out the incidence of it being cancerous or infected.   A portion of the lesion may be scraped and sent to the laboratory for examination. Other tests like allergy tests or blood tests may be done.

Prevention of Nummular Dermatitis

To help prevent Nummular Dermatitis, certain agents and conditions should be avoided. They are:

• Clothing fibers that irritate skin. It is preferable to wear loose, cotton clothing and avoid fabrics like wool or jute.
• Excessive bathing, hot water soaks and showers that can dry out skin further.
• Harsh soaps and shower gels
• Cosmetics and perfumes that may contain alcohol
• Stressful situations
• Environmental irritants like certain chemicals found in cleaning liquids, fabric softeners and air sprays
• Any situation that causes abrasion to the skin such as wearing tight clothing or rubbing against an abrasive surface
• Getting scrapes, cuts, and bruises.

Treatment of Nummular Dermatitis

If treatment is administered well, the condition can go away completely.  The treatments aim at rehydrating the skin, repairing the irritated skin, reducing inflammation and treating any infection. Some of the common modes of treatment are:

Dressings – if the patches are spreading, or if the fluid is oozing out, moist bandages can be used to cover the affected area and to prevent it from spreading to other parts.

Moisturizers – This is a good way to prevent this skin condition and to add to treatment. The skin has to be kept well moisturized to avoid further aggravation due to temperature and weather fluctuations. Unscented lotions, creams, and emollients can be used to prevent an outbreak.

Wet wrap treatments – This is done by getting the skin moist by lukewarm water to make sure it is well hydrated and then applying a topical ointment liberally. This process is repeated around 4-6 times a day.

Steroid medication or injections – This is the most commonly used form of treatment. These are administered to the patient mainly to soothe the inflammation caused. If the lesions itch less, they can be treated with less potent steroids. If the patches are severely inflamed and itch severely, then steroids of a higher potency may be administered. The medicine will be applied to the moist skin so as to allow deeper penetration and faster healing.

Tar medications – Tar medications applied topically are found to be very effective especially in reducing thickened or scaly lesions.

Oral histamines – These are taken to relieve the sensations of itching and discomfort. They may be prescribed along with sedatives to allow better sleep.

Antibiotics – In case the lesions have become infected, antibiotics can be administered to treat the infections. Topical antibiotics like mupirocin and oral antibiotics like erythromycin and cephalexin will be used in case of secondary infections.

Phototherapy – this involves using ultraviolet radiation to reduce the skin’s inflammation. This treatment is found to be beneficial in severe cases.

Nummular Dermatitis Pictures

Nummular Dermatitis is a rare condition where the skin develops coin-shaped lesions which may be itchy. The lesions are usually seen after a skin injury and are aggravated by certain weather and environmental conditions.  Treatments involve using topical medications and keeping skin well moisturized.

Medical References:

aad.org/public/diseases/eczema/nummular-dermatitis

emedicine.medscape.com/article/1123605-overview

nationaleczema.org/eczema/types-of-eczema/nummular-eczema/

webmd.com/skin-problems-and-treatments/eczema/picture-of-nummular-eczema

medlineplus.gov/ency/article/000870.htm

msdmanuals.com/professional/dermatologic-disorders/dermatitis/nummular-dermatitis

skinsight.com/skin-conditions/adult/nummular-dermatitis

mdedge.com/edermatologynews/dsm/440/dermatology/nummular-dermatitis-nummular-eczema

derm101.com/therapeutic/nummular-dermatitis-2/overview/

dermaharmony.com/dermatitis/nummulardermatitis.aspx