Nummalar Eczema – Complete Information
Table of Contents
What is Nummular Eczema?
Nummular eczema, also known as discoid eczema, is a form of eczema characterized by multiple coin-shaped lesions. This chronic inflammatory skin disease commonly involves the extremities and, less commonly, the trunk.
What causes Nummular Eczema?
The exact cause of nummular eczema is unknown. Somes causes are as follows:
- Dry skin
- Contact allergy to metals like nickel, various dyes, lanolin and fragrance
- Drinking too much alcohol (or alcohol at all)
- Decreased cutaneous lipid production
- Environmental air-borne allergens
- Staphylococcal colonization
- Getting stressed
- Use of irritating drying soaps
- Bathing frequently with hot water
- Environments with low humidity
- Skin trauma like a bug or mosquito bite and itching the affected area.
- Exposure to rough fabrics such as wool, breast implantation, and certain medications (antivirals, interferon, antidepressants, guselkumab, ribavirin, isotretinoin, statins, retinoids, gold compounds and diuretics).
- Chronic venous stasis can lead to development of nummular dermatitis in the lower extremities.
How to treat and manage Nummular Eczema?
Moisturizing the affected area and avoiding behaviours like itching can help manage nummular eczema.
Treatments you can do at home:
- Thick emollients (petroleum jelly) or ointments is highly recommended. Moisturizers containing ceramides can also be used.
- Try to take short (≤5 minutes) lukewarm showers, use gentle hydrating, fragrance-free soaps or avoid soaps, and apply emollients immediately after showering while the skin is still slightly wet. You can also add bath oil or use an oil body cleanser for your bath.
- You can try apple cider vinegar, epsom bath salt, collodial oatmeal or bleach baths but it is not recommended.
- Drink lots of water to stay hydrated.
- Avoid tight clothing (cotton is best)and irritating fabrics and use a humidifier.
- Avoid alcohol in any skin or household products: shampoo, conditioner, lotion, deodorant, hand soap, air freshener, laundry detergent, dish soap, etc. You can use a glove to wash dishes or laundry.
- Do patch testing to know what you’re allergic to.
- Make sure to get a bacterial swab cultural from one of the spots to make sure there is not a secondary infection that need treating. If there is, your doctor will give you a prescription antibacterial ointment.
- Antihistamines may be used to provide relief for severe pruritus, especially at nighttime.
- Install a water softener to see if there is any difference.
- You could aso try diet/supplements.
- Make sure to use sunscreen (mineral-based).
- Soak and Smear technique with a steroid ointment might work for some people:
- Soak in lukewarm water for 20 minutes in the tub
- After that get out out the tub and immedietly smear the ointment onto the affected areas, then
- let everything air-dry before putting on pajamas/clothes
Topical therapies:
High or ultra-high potency topical corticosteroids applied directly to affected skin 1 to 2 times daily can help decrease inflammation and pruritus. Topical calcineurin inhibitors like tacrolimus, pimecrolimus may be used if you don’t want to deal with steroids. A typical alternating schedule includes topical corticosteroids on weekdays and topical calcineurin inhibitors on weekends. For isolated recalcitrant lesions, intralesional triamcinolone may be a treatment option.
Phototherapy:
For disease that is widespread, narrowband UVB light therapy can be used 2 to 3 times weekly. The therapy should be discontinued if a response is not noted after 30 treatments. In patients who respond, the frequency should be reduced to once weekly for a month, then to every other week for 2 months, as needed and tolerated.
Systemic Therapies:
If light therapy is not available, systemic immunosuppressants and immunomodulators can be used. Some of them are: systemic corticosteroids, methotrexate, cyclosporine and dupilumab (a biologic approved for the treatment of moderate to severe atopic dermatitis and is very effective in treating different types of eczema).
Frequently Asked Questions:
Is Nummular Eczema a fungal infection?
No, nummular eczema is not a fungal infection. it is a type of eczema.