Nummular Eczema

Nummular Eczema, also known as Nummular Dermatitis is characterized by round or oval-shaped itchy patches of tiny blisters. These later develop into a scabby, scale-like plaque that can appear anywhere on the skin, but most commonly on the back of the legs, arms and buttocks. The incidence of this condition is somewhat rare with less than two cases in 1000 people developing symptoms. It normally occurs (and reoccurs) in people in their 60s and is more common in men.

Symptoms

The lesions usually start out as papules, which over a period of days or weeks can ooze and form crusts. The lesions are normally itchy. During reoccurrences, new lesions can appear in the same locations as old lesions. As the lesions progress from papules, to crusty plaques, to flattened macules, they take on a brown appearance that gradually lessens with time, but may never completely disappear.

The exact cause(s) of Nummular Dermatitis is not known. However, a history of “dry” skin or other types of skin conditions (i.e. contact dermatitis, atopic dermatitis) is associated with this disease. Dry, winter conditions can increase the likelihood of flare-ups, and stress or caffeine can worsen the condition. Sometimes, various types of skin irritants (e.g. arthropod bites, contact with chemicals) can precede an outbreak.

Treatment

Treatment options are available, but may not be too effective. Topical steroids and oral antihistamines may help reduce inflammation and itching. Tar preparations can help with older, thickened, scaly plaques. Oral antibiotics may be used in cases of secondary infection.

After the outbreak subsides, keeping the skin well moisturized can lower the likelihood and/or severity of a reoccurrence.

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