Nummular eczema

Num­mu­lar ecze­ma is a form of ecze­ma with strikin­gly round, coin-shaped patches. It occurs pre­fe­ren­ti­al­ly on the lower legs, fore­arms and backs of the hands and affects men in midd­le and older age more frequently.

Cau­ses

The basis is usual­ly pro­no­un­ced skin dry­ness with a dis­tur­bed bar­ri­er. Cold, dry air in win­ter, hot show­ers, cont­act with irrit­ants and bac­te­ri­al colo­ni­sa­ti­on of the skin encou­ra­ge its deve­lo­p­ment. Some pati­ents addi­tio­nal­ly have cont­act allergies.

Sym­ptoms

Typi­cal are shar­ply defi­ned round plaques one to five cen­ti­me­t­res in dia­me­ter that may be red, wee­ping or crus­ted. Itching is usual­ly pro­no­un­ced. The lesi­ons heal from the cent­re out­wards and tem­po­r­a­ri­ly lea­ve dar­ker or ligh­ter areas.

Tre­at­ment

Con­sis­tent emol­li­ent basic care is important, sup­ple­men­ted by anti-inflamm­a­to­ry pre­pa­ra­ti­ons in the acu­te stage. If bac­te­ri­al colo­ni­sa­ti­on is pre­sent, anti­sep­tic or anti­bio­tic tre­at­ment may be neces­sa­ry. Con­tri­bu­ting fac­tors such as showe­ring too hot and too often should be redu­ced, other­wi­se the con­di­ti­on tends to relapse.