184.108.40.206 Nummular Dermatitis
Grading & Level of Importance: B
Discoid eczema; Nummular eczema
Dermatitis with sharply-bordered, coin-shaped patches or plaques.
Aetiology & Pathogenesis
Mostly unknown. Microbial colonization, local trauma. Sometimes associated with dry skin and stasis dermatitis. In many patients, particularly children, it is a manifestation of atopic dermatitis.
Signs & Symptoms
Nummular (circular or oval = coin-shaped), exudative patches and plaques, often with crusts. Pruritus, and sometimes excoriations.
Sites of predilection: Extremities (lower legs, hands, forearms), trunk occasionally in a symmetrical distribution.
Different patterns: Discoid eczema of the hands and forearms. Discoid eczema of the limbs and trunk. “Dry” discoid eczema.
Laboratory & other workups
Scales: Direct microscopic examination to exclude fungal infection.
Typical histology for dermatitis reflecting acute/subacute nature of lesion, usually few eosinophils (see Atopic Dermatitis).
Chronic, with recurrent flares, may be somewhat resistant to therapy.
Secondary bacterial infection.
Clinical features, sometimes histopathological examination and exclusion of fungal infection.
Prevention & Therapy
Topical corticosteroids or combinations of corticosteroids with antimicrobials. Acute lesions: Local astringent measures and antiseptics. Disseminated forms: Occasionally oral antibiotics and systemic corticosteroids. Prevention: Emollients and avoidance of irritants.
Further Images / DOIA
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