Nummular Dermatitis

Dermatitis (inflammation of the skin) presenting as disc- or coin-shaped lesions is called nummular or discoid dermatitis. This type of dermatitis is commonly seen among middle-aged or elderly patients and is associated with the presence of dry skin and cold weather. The cause of this condition is unknown, though id reactions (autoeczematization) may present as nummular dermatitis. Diagnosis is made clinically, and it can be treated with antibiotics, corticosteroids, or ultraviolet radiation therapy.

Nummular Dermatitis is the result of the following process: auto-immune.

Presentation

Nummular dermatitis may present with a history of pruritic eruptions in the legs lasting for days to months, which may wax and wane with changes in temperature or climate. The lesions and pruritus may improve with the use of moisturizers or exposure to the sun or higher humidity. Patients with nummular dermatitis often have a prior history of atopic conditions such as atopic dermatitis or eczema and may exhibit dry and sensitive skin. The lesions are described as very itchy and may also produce a burning sensation.

Nummular dermatitis is diagnosed through the presence of characteristic round-to-oval erythematous plaques symmetrically distributed in the extensor aspects of the lower extremities or other areas of the body including the trunk, hand, or feet [9]. The initial lesions are papulovesicular in nature, and they may develop yellowish crusts when superinfected with staphylococci. They eventually coalesce to form 2 to 10 cm diameter scaly plaques that exhibit central clearing, a feature also seen in tinea corporis. An important exclusion criteria is the presence of lesions on the face and scalp, which is not typically seen in nummular dermatitis.

Nummular dermatitis is commonly seen in elderly males and younger females. This condition is uncommon in children.

Skin
Dermatitis
  • […] are known to cause contact dermatitis superimposed on nummular dermatitis.[en.wikipedia.org]
  • Dermatitis (Treatment) Nummular Dermatitis (Diagnosis) more research...»[rightdiagnosis.com]
  • Type 2 Excludes chronic (childhood) granulomatous disease ( D71 ) dermatitis gangrenosa ( L08.0 ) dermatitis herpetiformis ( L13.0 ) dry skin dermatitis ( L85.3 ) factitial dermatitis ( L98.1 ) perioral dermatitis ( L71.0 ) radiation-related disorders[icd10data.com]
Eczema
  • Treating discoid eczema (nummular eczema) is now even easier with Eczema-Ltd III.[eczema-ltd.com]
  • Symptoms of discoid eczema Discoid eczema causes distinctive circular or oval patches of eczema.[nhs.uk]
  • There are several types of eczema.[patient.info]
  • Discoid eczema can occur in atopic eczema , eczema craquelé and secondary eczematisation .[dermnetnz.org]
Nummular Dermatitis
  • Causes of Nummular dermatitis Read more about causes of Nummular dermatitis .[rightdiagnosis.com]
  • Nummular dermatitis Nummular dermatitis: Overview Nummular dermatitis: Symptoms Nummular dermatitis: Causes Nummular dermatitis: Treatment Nummular dermatitis: Tips[aad.org]
  • A severe case of nummular dermatitis.[nationaleczema.org]
Eruptions
Erythema
  • […] ab igne DL531 Erythema annulare centrifugum DA692F Erythema chronicum migrans DL951 Erythema elevatum diutinum DL271C Erythema fixum fa lægemiddel DL519 Erythema multiforme UNS DL511 Erythema multiforme bullosum DL518A Erythema multiforme majus DL510[mobilvejning.dk]
  • Images hosted on other servers: Redness (erythema) and mild scaling Light pink papules Microscopic (histologic) description Acute, subacute or chronic spongiotic dermatitis In acute lesions, there is focal, usually mild, spongiosis with overlying scale[pathologyoutlines.com]
  • Codes Adjacent To L30.0 L29.3 Anogenital pruritus, unspecified L29.9 Pruritus, unspecified L30 Other and unspecified dermatitis L30.0 Nummular dermatitis L30.1 Dyshidrosis [pompholyx] L30.2 Cutaneous autosensitization L30.3 Infective dermatitis L30.4 Erythema[icd10data.com]
  • […] exsudativum multiforme, Epydermolysis bullosa hereditaria dystrophica recessiva, Dermatitis seborrhoica, Erythema nodosum, Pemfigus vulgaris, Dermatitis herpetiformis Duhring, Lupus erythematosus systemicus, Herpes simplex infections, Pap:illoma virus[google.com]
  • Infected eczema shows erythema with exudation and crusting.[drmhijazy.com]
Pruritus
  • Antihistamines can reduce pruritus and aid sleep.[patient.info]
  • , unspecified L29.9 Pruritus, unspecified L30 Other and unspecified dermatitis L30.0 Nummular dermatitis L30.1 Dyshidrosis [pompholyx] L30.2 Cutaneous autosensitization L30.3 Infective dermatitis L30.4 Erythema intertrigo L30.8 Other specified dermatitis[icd10data.com]
  • Hydration of the skin is important in that it helps to improve the dryness and pruritus and restore the disturbed skin’s barrier function.[consultant360.com]
  • Pruritus, often worst at night, may cause irritability, insomnia, or both.[emedicine.medscape.com]
  • Sering pada anak-anak 5 tahun : 10-20 % pada dewasa : 1-3 %, 1,3 : 1 GK Tampak lesi plak seukuran uang logam Vesikel berdinding tipis pada dasar eritematous Plak kronis kering, berskuama, likenifikasi Pruritus Eritema Papul vesikel Likenifikasi PP Patch[docslide.com.br]
Chronic Dermatitis
  • Eczema is a form of chronic dermatitis (rash).Allergic reaction is one of the important causes of eczema .[healthquestions.medhelp.org]
  • […] vesicular dermatitis Dyshidrosis Dyshidrotic eczema Pompholyx (cheiropompholyx, podopompholyx) Vesicular eczema of palms and soles Nummular dermatitis: Discoid dermatitis Microbial dermatitis Nummular eczema Orbicular eczema Exudative discoid and lichenoid chronic[derm101.com]
  • People suffering from acute dermatitis have blisters, crusting, and scaling, particularly in those people with subacute dermatitis, while chronic dermatitis sufferers experience hardening or thickening of the skin, also known as lichenification.[organicfacts.net]
  • ATOPIC DERMATITIS atopic dermatitis Chronic dermatitis of unknown cause found in patients with a history of allergy.[medical-dictionary.thefreedictionary.com]
Skin Patch
  • The skin patches are usually very itchy.[patient.info]
  • The affected areas, usually the arms and legs, present itchy skin patches with small blisters The condition is commonly seen in older men and younger women.[dovemed.com]
Exanthema
  • DL858F Erythrokeratodermia variabilis DK132C Erythroplakia linguae DD974 Erythroplasia Queyrat (erythroplasia penis )(se carcinoma in situ) DL081 Erytrasma DL539A Erytrodermi UNS DQ803 Medfødt bulløs iktyosiform erytrodermi DI738D Erytromelalgi DL270A Exanthema[mobilvejning.dk]
Skin Plaque
  • Description The term nummular means coin-shaped, so both terms describe the characteristic round (or oval) erythematous skin plaques.[patient.info]
Dermatologic Disorder
  • It is an allergy-related, dermatological disorder that causes development of coin-shaped, itchy spots or patches over the skin surface.[hxbenefit.com]
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  • urogenital
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  • neurologic
    Irritability
    • If no irritation develops within a few days, another patch test is performed.[encyclopedia.com]
    • Avoidance of irritants is a common strategy.[en.wikipedia.org]
    • Irritant Contact Dermatitis: This occurs due to exposure to various irritants.[organicfacts.net]
    • Contact dermatitis is triggered by allergens or irritating substances. 80 per cent of all contact dermatitis cases are caused by an irritant. 2.[babydermatitis.com]
    • Many rashes are itchy, red, painful, and irritated.[icdlist.com]
    Confusion
    • Nummular Eczema Nummular eczema is often confused with nummular psoriasis, but it is important to realize that it is a type of eczema and NOT psoriasis.[psoriasis-causes-and-treatment.com]
    • […] typically not necessary, and cannot be used to rule out other atopic dermatitis or other eczemas. [9] [10] However, patch testing may be employed to rule out irritants ( contact dermatitis ) as a cause. [6] [11] In children, nummular dermatitis is commonly confused[en.wikipedia.org]
    • Nummular eczema is frequently confused with, and misdiagnosed as, ringworm [tinea corporis].[coinbooks.org]
    • […] infection The result of a local physical or chemical injury An allergy to aloe, hair removal creams, mercury and other irritants The result of very dry skin Excessive alcohol consumption The result of prescription drugs Extreme stress Sometimes people will confuse[amoils.com]
    • Some confuse it with 'ringworms' but there are no parasites involved, just irritated red skin.[eczema-ltd.com]
  • more...
  • Face, Head & Neck
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  • Entire body system
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  • Workup

    A biopsy of the lesion may be performed after excluding tinea corporis through scraping and microscopic examination of the specimen using potassium hydroxide. Biopsy findings of nummular dermatitis lesions are characterized by nonspecific lymphocytic infiltrates, spongiosis, and eosinophils in the papillary dermis. Hyperkeratosis, epidermal hyperplasia, and a thickened granular cell layer may be seen in chronic lesions.

    Swab cultures of lesions with yellowish crusting may be performed to detect the presence of methicillin-resistant Staphylococcus aureus (MRSA) in order to choose the proper antibiotic therapy. Testing for other infections such as H. pylori and Giardia may also be required [10].

    Pathology

    Other Pathologies
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  • Biopsy
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  • Laboratory

    Microbiology
    Staphylococcus Aureus
    • Some cases are associated with Staphylococcus aureus infection .[dermnetnz.org]
    • The most common organism revealed by culture is Staphylococcus aureus.[emedicine.medscape.com]
    • Studies have implicated nickel, cobalt, chromate, and fragrance as likely culprits. [6] [7] Xerosis , or dehydration of skin is also a likely cause. [8] Infection with Staphylococcus aureus bacteria or Candida may also play a role. [8] Diagnosis [ edit[en.wikipedia.org]
    • Infection is Often Associated It is often associated with an infection with a virus like molluscum, or with Staph (Staphylococcus aureus) somewhere else on the body.[blog.cherylleemd.com]
    Candida
    • Studies have implicated nickel, cobalt, chromate, and fragrance as likely culprits. [6] [7] Xerosis , or dehydration of skin is also a likely cause. [8] Infection with Staphylococcus aureus bacteria or Candida may also play a role. [8] Diagnosis [ edit[en.wikipedia.org]
    • […] respiratory tract, was found in 68% of patients in one study. 5 Eleven of thirteen patients without a history of atopic eczema improved after odontogenic infections were treated. 6 A role for environmental allergens, such as the house dust mite and Candida[accessmedicine.mhmedical.com]
    • To avoid developing a secondary Candida yeast infection in body creases or folds, the patient is advised to cleanse these areas carefully, to dry gently but thoroughly, and to ensure that the skin is well aerated.[medical-dictionary.thefreedictionary.com]
  • more...
  • Treatment

    The primary treatment for nummular dermatitis involves skin rehydration in order to restore the epidermal lipid barrier. This is achieved through lukewarm or cool baths or soaking the affected area for 20 minutes in order to rehydrate the skin, followed by the application of a steroid ointment or petrolatum to the wet skin. This method has been reported to produce a greater response in >90% of patients with chronic refractory pruritic eruptions [11]. However, the patient should be instructed not to use soaps when performing this technique. Wet wrap treatments are also helpful, and this involves the procedures mentioned above, followed by occlusion with a damp cloth or a non-breathable material for 1 hour.

    Another treatment goal in the management of nummular dermatitis is the control of inflammation using several medications. Steroids are the most commonly used drugs. Low-potency steroids (Class III-VI) are indicated for less pruritic or less erythematous lesions, whereas lesions with severe inflammation or intense pruritus may be treated with high-potency steroids (Class I-II). Severe, generalized nummular dermatitis may require oral, intramuscular, or intravenous steroids. Long-term use of steroids should be avoided. Other medications to decrease inflammation include immune modulators such as tacrolimus and coal tar.

    Infected lesions require treatment with antibiotics such as dicloxacillin, erythromycin, tetracycline, or cephalexin. Ideally, swab cultures should be the basis in the selection of an antibiotic.

    Patients with severe, generalized, refractory nummular dermatitis may benefit from phototherapy using psoralen + UVA (PUVA) or UVB radiation.

    Prognosis

    Nummular dermatitis is a recurrent disease. Lesions may take a year or several years before they resolve, and they may reappear in the same sites as the initial outbreak. Proper treatment may cause complete resolution, though darker or lighter spots may replace the lesions in the affected areas, especially in the thighs, legs, and feet. Control of recurrences may be partially achieved by avoidance of exacerbating factors and hydration of the skin.

    Complications

    Staphylococcus Aureus Infection
    • Some cases are associated with Staphylococcus aureus infection .[dermnetnz.org]
    • aureus infection, might play a role either directly or through a hypersensitivity mechanism. 8,9 Helicobacter pylori infection has also been implicated in the pathogenesis in some cases. 10 Nummular eczema is more frequent in persons with atopy and can[consultant360.com]
    Contact Dermatitis
    • This study is aimed at evaluating secondary contact dermatitis in patients with nummular dermatitis.[ijdvl.com]
    • "Contact dermatitis: diagnosis and management."[encyclopedia.com]
    • Biopsies are typically not necessary, and cannot be used to rule out other atopic dermatitis or other eczemas. [9] [10] However, patch testing may be employed to rule out irritants ( contact dermatitis ) as a cause. [6] [11] In children, nummular dermatitis[en.wikipedia.org]
    • Here we are in 2008 and I have been through 5 days of testing at the UCSD hospital for contact dermatitis and zero![healthquestions.medhelp.org]
    Tinea Versicolor
    • Pimples Pityriasis rosea Pityriasis versicolor Plaque psoriasis Poison ivy Psoriasis Psoriatic arthritis Pustular psoriasis Rosacea Scabies Scalp psoriasis Seborrheic dermatitis Seborrheic keratoses Shingles Skin cancer Spitz nevus Squamous cell carcinoma Tinea[cincoderm.com]
    Chronic Dermatitis
    • Eczema is a form of chronic dermatitis (rash).Allergic reaction is one of the important causes of eczema .[healthquestions.medhelp.org]
    • […] vesicular dermatitis Dyshidrosis Dyshidrotic eczema Pompholyx (cheiropompholyx, podopompholyx) Vesicular eczema of palms and soles Nummular dermatitis: Discoid dermatitis Microbial dermatitis Nummular eczema Orbicular eczema Exudative discoid and lichenoid chronic[derm101.com]
    • People suffering from acute dermatitis have blisters, crusting, and scaling, particularly in those people with subacute dermatitis, while chronic dermatitis sufferers experience hardening or thickening of the skin, also known as lichenification.[organicfacts.net]
    • ATOPIC DERMATITIS atopic dermatitis Chronic dermatitis of unknown cause found in patients with a history of allergy.[medical-dictionary.thefreedictionary.com]
    Dehydration
    • "From Xerosis to Nummular Dermatitis: The Dehydration Dermatosis" .[en.wikipedia.org]
    • Causes of nummular eczema can be poor by stress and increased usage of caffeine which dehydrates the body and hence the skin.[omicsonline.org]
    • Other forms of dermatitis are at risk of developing, and patch testing may be helpful in diagnosis. [ 3 ] Other causes Nummular eczema can also be worsened by stress and excessive caffeine, which dehydrates the body and thus the skin. [ citation needed[research.omicsgroup.org]
    • The site further maintains that stress and excessive caffeine dehydrates the body and thus can worsen the condition.[peashealth.com]
    • Taking long baths with hot water should be avoided as this leads to a dehydration of the skin.[eczemaexpert.org]
    Autoeczematisation
    • Severe discoid eczema may generalise, with numerous small to large itchy lesions appearing all over the body due to autoeczematisation reaction.[dermnetnz.org]
    Tinea Corporis
    • Nummular eczema is frequently confused with, and misdiagnosed as, ringworm [tinea corporis].[coinbooks.org]
    • However, a potassium hydroxide wet-mount examination of skin scrapings should be performed if tinea corporis is suspected.[consultant360.com]
    • Plaques may clear in the centre and resemble tinea corporis.[patient.info]
    • corporis . [8] Epidemiology [ edit ] The prevalence of nummular dermatitis in the United States is approximately 2 per 1,000. [12] It is considered a disease of adulthood, for it is rare in children. [13] Treatment [ edit ] One of the keys to treatment[en.wikipedia.org]
    • Other conditions that can resemble nummular dermatitis include psoriasis, tinea corporis and parapsoriasis (although this is usually not itchy). .[eczemaguide.ca]
    Skin Infection
    • If a bacterial skin infection occurs, your dermatologist will prescribe an antibiotic.[aad.org]
    • A skin infection caused by bacteria.[susongderm.com]
    • infections or abrasions Heightened sensitivity to certain substances, including rubber, nickel, formaldehyde and mercury, may also play a role in triggering an outbreak.[health.howstuffworks.com]
    • Nummular eczema that results in a bacterial skin infection will need an antibiotic for treatment.[everydayhealth.com]
    • Individuals with discoid or nummular exema have the capacity to develop additional secondary skin infections or other forms of dermatitis.[hollywoodbeautysecrets.com]
    Infection
    • Clinical Features The distinction between infective and infected eczema is difficult.[drmhijazy.com]
    • Infection of the inflamed patches is quite common.[patient.info]
    • Infection is Often Associated It is often associated with an infection with a virus like molluscum, or with Staph (Staphylococcus aureus) somewhere else on the body.[blog.cherylleemd.com]
    • Infected eczema If your eczema has become infected, you will usually be prescribed an antibiotic.[hse.ie]
    • See also Special Topic Secondary infections A secondary infection is an infection that occurs during or after treatment for another infection.[scripps.org]
    Atopic Dermatitis
    Nummular Dermatitis
    • Causes of Nummular dermatitis Read more about causes of Nummular dermatitis .[rightdiagnosis.com]
    • Nummular dermatitis Nummular dermatitis: Overview Nummular dermatitis: Symptoms Nummular dermatitis: Causes Nummular dermatitis: Treatment Nummular dermatitis: Tips[aad.org]
    • A severe case of nummular dermatitis.[nationaleczema.org]
    Eczema
    • Treating discoid eczema (nummular eczema) is now even easier with Eczema-Ltd III.[eczema-ltd.com]
    • Symptoms of discoid eczema Discoid eczema causes distinctive circular or oval patches of eczema.[nhs.uk]
    • There are several types of eczema.[patient.info]
    • Discoid eczema can occur in atopic eczema , eczema craquelé and secondary eczematisation .[dermnetnz.org]

    Etiology

    Although the etiology of nummular dermatitis is unknown, triggers such as local trauma (abrasions or insect bites), contact dermatitis (irritant or allergic), and exposure to chemicals may cause its development. The etiology is also likely multifactorial, and there have been some reports of sensitivity to metals and drugs such as cobalt, nickel sulfate, nitrofurazone, and neomycin causing nummular dermatitis. Other substances that may be associated with its development include potassium thioglycolate (found in depilating creams) [1], glue containing ethylcyanoacrylate, tincture of thimerosal [2], or mercury-containing dental amalgams [3]. Autoeczematization, defined as the spread of lesions from an initial focus, is often associated with the presence of multiple plaques [4]. Interferon and ribavirin therapy for hepatitis C [5] and tumor necrosis factor inhibitors [6] may cause severe, generalized nummular dermatitis. Patients with nummular dermatitis often have very dry or xerotic skin.

    Both upper and lower extremities may be affected, and conditions associated with its development in the lower extremities include edema, venous stasis, varicose veins, and venous insufficiency.

    Causes

    Dehydration
    • "From Xerosis to Nummular Dermatitis: The Dehydration Dermatosis" .[en.wikipedia.org]
    • Causes of nummular eczema can be poor by stress and increased usage of caffeine which dehydrates the body and hence the skin.[omicsonline.org]
    • Other forms of dermatitis are at risk of developing, and patch testing may be helpful in diagnosis. [ 3 ] Other causes Nummular eczema can also be worsened by stress and excessive caffeine, which dehydrates the body and thus the skin. [ citation needed[research.omicsgroup.org]
    • The site further maintains that stress and excessive caffeine dehydrates the body and thus can worsen the condition.[peashealth.com]
    • Taking long baths with hot water should be avoided as this leads to a dehydration of the skin.[eczemaexpert.org]
    Bacteria
    • Hypersensitivity to bacteria in eczema.[drmhijazy.com]
    • Bacteria infections can become present if conditions are not sanitary with resulting infections.[eczema-ltd.com]
    • Scratching the skin surface can also lead to the development of secondary infections from certain viruses, fungi and bacteria.[eczemaexpert.org]
    • If you develop an infection related to nummular dermatitis, a doctor can prescribe an antibiotic, which protects the skin by destroying bacteria.[sharecare.com]
    • Studies have implicated nickel, cobalt, chromate, and fragrance as likely culprits. [6] [7] Xerosis , or dehydration of skin is also a likely cause. [8] Infection with Staphylococcus aureus bacteria or Candida may also play a role. [8] Diagnosis [ edit[en.wikipedia.org]

    Epidemiology

    One of the most common dermatological conditions is dermatitis in all its forms. Nummular dermatitis is a type of dermatitis with a prevalence of 2 cases for every 1000 individuals, and this pattern is observed both globally and in the United States. This condition has been found to affect more males than females but has no racial predilection. It is usually more common during 60-70 years of age in males, with a smaller peak occurring during the second and third decades of life in women, especially those with atopic dermatitis. This condition is rare in children.

    Sex distribution
    Age distribution

    Pathophysiology

    The exact pathophysiology of nummular dermatitis is unknown. However, the presence of xerosis (dry skin) may promote its development by causing dysfunction of the epidermal lipid barrier, which facilitates the entry of allergens into the skin to induce an allergic or irritant response [7] [8].

    Hypersensitivity to metals may trigger nummular dermatitis. It is believed that the mercury present in dental amalgams induces an immune response that causes the development of the lesions.

    Histamine and mast cells play a key role in the intense pruritus seen in nummular dermatitis. There are a greater number of mast cells present in nummular dermatitis lesions compared to normal skin, and the mast cells of patients with nummular dermatitis have a lower chymase activity. This leads to the impaired ability of the enzyme to suppress inflammation due to inadequate degradation of neuropeptides and protein, substances that potentiate the inflammatory response.

    Prevention

    Since the condition is associated with dry skin, prevention requires aggressive skin hydration and avoidance of cleansers that damage the epidermal lipid barrier. Mild cleansers should be used and application of emollients after bathing may decrease the chances of eruptions. Soaps should be avoided since they damage the lipid layer of the skin, the structure responsible for retaining moisture inside the skin. 

    Patients should wear loose-fitting clothes to prevent overheating, and fibers that have the potential to irritate the skin such as wool or polyester should be avoided. Extremes in temperature should also be evaded and the use of humidifiers may help control the condition.

    Summary

    Nummular dermatitis is a form of skin inflammation characterized by multiple, round or oval erythematous plaques on the upper and lower extremities. It is considered as a form of eczema. Initial lesions start out as papules and coalesce to form oval or discoid lesions, which may or may not contain vesicles with serous exudate. These highly pruritic lesions eventually form plaques with scales, and yellowish crusting may be present in some lesions infected with bacteria. It normally erupts in the extremities and affects both females and males albeit in different age distributions.

    Patient Information

    Nummular dermatitis is a type of dermatitis characterized by red, itchy, coin-shaped rashes that may or may not have blisters or scales. The skin lesions may start out as tiny blisters that eventually come together to form a bigger rash. They usually form at the backs of the arms, legs, or buttocks. However, they can also appear on the torso.

    Although the cause of this disease is unknown, it has been associated with cold weather during winter, and is more common in older males (60-70 years old) and younger women (20-30 years old). The rash may spontaneously disappear and reappear without any apparent reason.

    This condition may be treated with moisturizers since it is associated with dry, sensitive skin. Antibiotics may be prescribed if the rashes are infected, and corticosteroid creams, injections, or pills may be administered if there is inflammation. Phototherapy using ultraviolet light may help in severe cases. However, the results of the treatment vary and may not be effective for all cases.

    Other symptoms

    No Eczema
    • Treating discoid eczema (nummular eczema) is now even easier with Eczema-Ltd III.[eczema-ltd.com]
    • Symptoms of discoid eczema Discoid eczema causes distinctive circular or oval patches of eczema.[nhs.uk]
    • There are several types of eczema.[patient.info]
    • Discoid eczema can occur in atopic eczema , eczema craquelé and secondary eczematisation .[dermnetnz.org]
    Aging
    Hypersensitivity
    • Similar to what is seen in delayed-type hypersensitivity reactions, clusters of Langerhans cells and eosinophils may be seen.[dermpedia.org]
    • It is linked to hypersensitivity as there may be a family history of allergies, atopic dermatitis, or similar disorders.[medical-dictionary.thefreedictionary.com]
    • Hypersensitivity to bacteria in eczema.[drmhijazy.com]
    • Hypersensitivity to the metals in the mouth is posulated to be sufficient to drive an immune response that results in cutaneous nummular plaques.[emedicine.medscape.com]
    • Atopic Dermatitis: This type of dermatitis results in long-term hypersensitivity to the skin.[organicfacts.net]
    Atopy
    • The pathogenesis of atopic dermatitis involves a complex interaction between atopy and environmental protein allergens which produces Th2 immune responses with IgE formation, Th2 cells dominate in lesions of atopic dermatitis, whereas Th1 and Th2 cells[clinicaltrials.gov]
    • The vast majority of patients with nummular eczema do not have a personal or family history of atopy, 2 , 3 although nummular plaques may be seen in atopic eczema.[accessmedicine.mhmedical.com]
    • Peradangan pada kulit dengan plak lingkaran sebesar mata uang logam & tepi berbatas jelas Peradangan kulit kronik residif disertai gatal yang umumnya sering terjadi selama masa bayi & anak-anak, sering berhubungan dengan peningkatan kadar IgE & riwayat atopi[docslide.com.br]
    • It may be caused by leukemias or lymphomas that infiltrate the skin; extensive psoriasis; drug reactions (such as vancomycin); allergies, seborrhea, or atopy.[medical-dictionary.thefreedictionary.com]
    • Staphylococcus aureus infection, might play a role either directly or through a hypersensitivity mechanism. 8,9 Helicobacter pylori infection has also been implicated in the pathogenesis in some cases. 10 Nummular eczema is more frequent in persons with atopy[consultant360.com]
    Adult Onset
    • "Adult-onset atopic dermatitis: a cross-sectional study of natural history and clinical manifestation" .[en.wikipedia.org]
    • In fact, some doctors actually consider discoid eczema as a form of adult-onset atopic (allergic) dermatitis.[patient.info]
    Staphylococcal Infection
    • There are many causes for nummular eczema and these include: A reaction to topical irritants A manifestation of winter dermatitis A manifestation of atopic dermatitis in children A complication from a staphylococcal infection The result of a local physical[amoils.com]
    • Early lesions, especially vesicles, often have staphylococcal infection, which produces a yellowish crust.[patient.info]
    Old Age
    • Nummular eczema is more common in young adulthood and in old age, occuring more often in the fall and winter months rather than the rest of the year.[amoils.com]
    • Due to this reason, old age is supposed to be associated with the condition in some way.[hxbenefit.com]
    Sever Disease
    • Usually mild ones are adequate but, in severe disease, stronger steroid applications may be required and, in very severe cases, oral steroids can be needed.[patient.info]
    Lavender Oil
    • Such oils can be created by mixing together vegetable oil as a base, along with a few drops of lavender oil.[organicfacts.net]

    Self-assessment

    Ask Question


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    References

    1. Le Coz C. Contact nummular (discoid) eczema from depilating cream. Cont Dermat. 2002. 46:111-112.
    2. Patrizi A, Rizzoli L, Vincenzi C, Trevisi P, Tosti A. Sensitization to thimerosal in atopic children. Contact Dermatitis. 1999 Feb. 40(2):94-7.
    3. Pigatto PD, Guzzi G, Persichini P. Nummular lichenoid dermatitis from mercury dental amalgam. Contact Dermatitis. 2002 Jun. 46(6):355-6.
    4. Bendl BJ. Nummular eczema of statis origin. The backbone of a morphologic pattern of diverse etiology. Int J Dermatol. 1979 Mar. 18(2):129-35.
    5. Shen Y, Pielop J, Hsu S. Generalized nummular eczema secondary to peginterferon Alfa-2b and ribavirin combination therapy for hepatitis C infection. Arch Dermatol. 2005 Jan;141(1):102-3.
    6. Flendrie M, Vissers WH, Creemers MC, de Jong EM, van de Kerkhof PC, van Riel PL. Dermatological conditions during TNF-alpha-blocking therapy in patients with rheumatoid arthritis: a prospective study. Arthritis Res Ther. 2005;7(3):R666-76. Epub 2005 Apr 4.
    7. Aoyama H, Tanaka M, Hara M, Tabata N, Tagami H. Nummular eczema: An addition of senile xerosis and unique cutaneous reactivities to environmental aeroallergens. Dermatology. 1999. 199(2):135-9.
    8. Ozkaya E. Adult-onset atopic dermatitis. J Am Acad Dermatol. 2005 Apr. 52(4):579-82.
    9. Jiamton S, Tangjaturonrusamee C, Kulthanan K. Clinical features and aggravating factors in nummular eczema in Thais. Asian Pac J Allergy Immunol. 2013 Mar. 31(1):36-42.
    10. Pigatto PD, Guzzi G, Persichini P. Nummular lichenoid dermatitis from mercury dental amalgam. Contact Dermatitis. 2002 Jun. 46(6):355-6.
    11. Gutman AB, Kligman AM, Sciacca J, James WD. Soak and smear: a standard technique revisited. Arch Dermatol. 2005 Dec. 141(12):1556-9.

    • Answer: Can you identify this condition? - O Potok, V Prajapati, B Barankin - Canadian Family Physician, 2011 - cfp.ca
    • Atopic dermatitis and the atopic march - JM Spergel, AS Paller - Journal of Allergy and Clinical Immunology, 2003 - Elsevier
    • Of Dendritic Cells Having Langerhans (T6+) and Interdigitating (RFD1+) Cell Immunophenotype in Psoriasis, Atopic Dermatitis, and Other Inflammatory - JD Bos, ID van Garderen, SR Krieg - Journal of investigative , 1986 - nature.com
    • A statistical analysis of a pediatric dermatology clinic - L Schachner, NS Ling, S Press - Pediatric dermatology, 2008 - Wiley Online Library
    • Of Dendritic Cells Having Langerhans (T6+) and Interdigitating (RFD1+) Cell Immunophenotype in Psoriasis, Atopic Dermatitis, and Other Inflammatory - JD Bos, ID van Garderen, SR Krieg - Journal of investigative , 1986 - nature.com
    • : employment of noninvasive biophysical instrumentation for the functional analyses of the mildly abnormal stratum corneum and for the efficacy assessment of skin - H Tagami, H Kobayashi, K O'goshi - Journal of cosmetic , 2006 - Wiley Online Library
    • 155 kD autoantibody The name of an antibody found most frequently in the blood of patients with clinically-amyopathic dermatomyositis. This is the form of - A Antimalarial - dermatology.cdlib.org

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