Nummular eczema

Nummular eczema

Chris Schach

Author Bio -

Key Points
*Type of dermatitis which most commonly affects the lower leg
*Exact cause is unknown
*Consists of round or oval brown, pink or red patches of skin which are dry and cracked or bumpy and blistered on their surface

Nummular eczema is a type of dermatitis which most commonly affects the lower leg. The condition consists of round or oval brown, pink or red patches of skin. The surface of these lesions may be dry and cracked, or may appear bumpy, blistered and crusted. In some cases, lesions are accompanied by severe itching. The condition may also become generalized, with lesions forming over large areas of the body. Hyper- and/or hypopigmentation may occur after lesions resolve.

The exact cause of nummular eczema is unknown, though it is often attributed to a combination of dry skin and immune system malfunction. Infants and children are sometimes effected and is fairly common in those in their 50's and beyond.  Additionally, the condition is susceptible to secondary bacterial infection.

Differential Diagnosis (Other conditions with similar appearance)
Asteatotic Eczema
Lichen Simplex Chronicus
Atopic Dermatitis
Pityriasis rosea
Contact Dermatitis
Psoriasis, Plaque
Tinea Corporis
Cutaneous T-cell lymphoma

    Key Points
    *Diagnosis based on skin appearance
    *Patch testing or skin swabs may be performed in some cases to confirm diagnosis

    Nummular eczema is generally diagnosed based on appearance. Patch testing or skin swabs of the affected area may be taken to confirm diagnosis.

    *Maintenance of healthy skin is a key factor for affected persons
    *Goal of treatment is to control symptoms and prevent infection
    *In moderate and severe cases, those diagnosed may be prescribed medications to assist in alleviating symptoms

    See our dry skin and eczema patient handout for recommendations.

    OTC Options: Non-soap Cleansers or moisturizing soaps, thick moisturizers

    Self-care of nummular eczema is a key factor in its treatment. Maintaining a moisturizing regiment, including the use of non-soap cleansers or moisturizing soaps, the application of thick moisturizers such as petroleum jelly after bathing, and minimizing exposure to elements which may exacerbate the condition, such as heat, humidity, soaps/detergents, abrasive materials, smoke/chemicals, and stress, are recommended by health care professionals to alleviate symptoms and minimize recurrence.

    In moderate and severe cases, health care professionals have several options for prescription treatments. Topical steroids can be used to treat affected areas, and oral antihistamines may be prescribed to reduce itching. If infection is present, topical or oral antibiotics may be used. Phototherapy may also be recommended. In severe cases, systemic steroids may be administered.