Nummular Eczema

Symptoms

Symptoms may include any of the following:

• Coin-shaped skin lesions that are dry and scaly, and appear on the arms and legs
• Lesions may spread to middle of body
• Lesions may ooze and become crusty
• Itching
• Scaly or raw skin
• Skin redness or inflammation

Exams and Tests

Your health care provider can usually diagnose this condition by looking at your skin and asking about your family's medical history.

A skin biopsy may be needed to rule out other similar conditions. Allergy testing may be done.

Treatment

Avoid triggers that can make your symptoms worse, such as wool, lanolin, and certain foods. Do not take frequent baths. Excess bathing and soap can cause dry skin, which often makes the condition worse. Also, avoid hot water while taking a bath or shower.

Your doctor may recommend skin lotion that repairs the barrier of the skin, special skin cleansers that are mild, or moist bandages to soothe scaly, dry, or healing areas. Antihistamines may be prescribed to relieve itching.

Persons with severe symptoms may be prescribed ointments that contain tar, corticosteroids, or other medicines that lower the immune system. In very severe cases, more powerful medicines called steroids are prescribed. These may need to be applied to the skin or taken by mouth.

Outlook (Prognosis)

Nummular eczema is a long-term (chronic) condition. Medical treatment and avoiding irritants can help reduce symptoms.

Possible Complications

A secondary infection of the skin may develop.

When to Contact a Medical Professional

Call your provider if you have symptoms of this condition.

Also call for an appointment if:

• Symptoms continue despite treatment
• You have signs of infection (such as fever, redness, or pain)

Prevention

There is no known way to prevent the disorder. Avoid any triggers that make your symptoms worse. Keep your skin moist and use gentle cleansers. Avoid things that irritate the skin.

References

Coulson I. Discoid eczema. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 59.

Reider N, Fritsch PO. Other eczematous eruptions. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 13.