There are many types of eczema. Nummular eczema can appear anywhere on the body, but is more common on the arms, legs, hands, and torso. This type of eczema causes round, coin-shaped patches of dry, itchy, and inflamed skin. The condition is chronic, meaning that it can last for a long time and recur frequently, especially in older individuals. It affects anyone, but it is more prevalent among men or people assigned male at birth.
Nummular eczema may be caused by various factors, including:
In winter or when using indoor heating, dry skin or dry environments are common.
Burns, scrapes, bug bites, or harsh chemicals can cause skin injury or irritation.
Metal, fabric, soap, or fragrance allergies or sensitivities.
A bacterial infection, such as staphylococcus, can worsen skin inflammation and cause oozing or crusting.
The immune system and skin barrier function can be affected by stress.
Some antibiotics, diuretics, and blood pressure medications can cause skin reactions.
The main symptom of nummular eczema is the appearance of round, red, scaly, and itchy patches on the skin. These patches can vary in size, from a few millimeters to several centimeters in diameter. They may also have tiny bumps or blisters that ooze clear fluid and crust over. Scratching these patches can result in skin infections, scars, or color changes. They can be extremely itchy and uncomfortable.
A dermatologist (a doctor who specializes in skin conditions) examines the skin and asks about the patient's medical history, symptoms, and possible triggers in order to diagnose nummular eczema. As an additional precaution, the dermatologist may perform a skin biopsy, which involves taking a small sample of skin and examining it under a microscope, in order to rule out other skin conditions which may cause similar patches, such as ringworm, psoriasis, or contact dermatitis. Using a skin biopsy can also help to identify any bacterial infections that may complicate the condition.
Among the treatment options for nummular eczema are: reducing inflammation, itching, and dryness of the skin, and preventing or treating infections.
Moisturizers hydrate and protect the skin barrier; they should be applied frequently, especially after bathing or showering, and should be fragrance-free.
It is possible to reduce the redness, swelling, and itching of patches with topical corticosteroids, which are creams or ointments that contain anti-inflammatory drugs. As these medications can cause skin thinning, stretch marks, or infections, they should be used sparingly and only as directed by the dermatologist.
The calcineurin inhibitor creams and ointments contain drugs that suppress the immune system, reducing inflammation and itching without the side effects of corticosteroids. These drugs should only be used as directed by the dermatologist, since they may cause burning, stinging, or increased skin sensitivity.
Antibiotics, which are pills or creams that kill bacteria. A dermatologist should prescribe these medications, and the full course should be completed to prevent antibiotic resistance in order to treat any skin infections caused by scratching or oozing of patches.
By using ultraviolet (UV) light, phototherapy can reduce the inflammation and itching of patches and improve skin appearance. Phototherapy uses controlled doses of radiation to treat the patches. In order to prevent side effects such as sunburn, skin aging, or skin cancer, phototherapy must be performed under the supervision of a dermatologist.
It is possible to treat severe or widespread cases of nummular eczema that do not respond to other treatments with systemic therapies. These include immunosuppressants, biologics, or oral corticosteroids. Using these drugs should only be done under the supervision of a dermatologist due to their serious side effects, including infections, liver damage, or bone loss.
Nummular eczema can be prevented by avoiding or minimizing exposure to triggers that cause or worsen the condition. Some preventive measures include:
Moisturizing and hydrating the skin with fragrance-free, gentle products.
Drying out the skin can be caused by long, hot, or frequent showers or baths.
By using mild, hypoallergenic soaps, detergents, and cleansers, and thoroughly rinsing them off.
Avoid wool, synthetics, and rough materials that can irritate the skin by wearing soft and breathable fabrics, such as cotton.
Some people are allergic to metals, such as nickel.
Use cold compresses, antihistamines, or topical anesthetics to relieve the itching, rather than scratching or rubbing the patches.
By practicing relaxation techniques, such as meditation, yoga, or breathing exercises, you can cope with stress, which can affect the skin and immune system.
If the patches become infected, oozing, or crusted, or if the symptoms don't improve, seek medical attention immediately.
