DISCOID ECZEMA                                                                            

Discoid eczema, also called nummular eczema or gravitational eczema is usually found in adults and appears suddenly as a few coin shaped areas of red skin; normally on the trunk or lower legs. It may look similar to ringworm. These areas become itchy and can weep fluid. Usually discoid eczema is treated with emollients (and steroid creams if necessary).It can be considered as an adult form of atopic eczema. It can be complicated by a bacterial infection which causes weeping and crusting.

The word "nummular" comes from the Latin nummus, meaning coin, and is characterized by round plaques of eczema. Eruptions of nummular eczema are often recurrent and chronic and usually appear in people who are in their 60s but can occur at any age. The cause of nummular eczema is not known, but it usually occurs in cold weather and is most common in people who have dry skin. Hot weather and stress can aggravate this condition, as can the following:

• Fabric softeners
• Allergies
• Soaps and detergents
• Wool clothing
• Bathing more than once a day.

Nummular eczema most commonly appears on the arms, back, buttocks, and lower legs that may be crusted, scaling, and extremely itchy. Neurodermatitis most commonly appears as scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch that becomes intensely irritated when scratched. Minor skin injury such as an insect bite or a burn may start it off.

Discoid eczema can affect any part of the body particularly the lower leg. It may be termed "varicose eczema" when it runs along the leg veins and result in gravitational eczema One or many patches appear, and may persist for weeks or months. They can be several centimeters across, or as small as two millimeters. The skin between the patches is usually normal, but may be dry and irritable. Discoid eczema may be extremely itchy, or scarcely noticeable. When the patches clear, they may leave marks for some weeks or months which are darker or sometimes paler than the normal skin tone. Discoid eczema does not run in families, and unlike atopic dermatitis, it is not associated with asthma. It does not result from food allergy. It is not infectious to other people, although it sometimes becomes secondarily infected by bacteria.

As this type of eczema often starts off as a minor skin injury, protect all your skin carefully. If the hands are affected, use gloves and tools to make sure the skin is not irritated by friction, detergents, solvents, other chemicals or excessive water.

An eruption may begin with one or numerous round red plaques with tiny overlying blisters. The plaques often enlarge to several centimeters with clearly marked edges, and overlying scale may be prominent. Swelling and oozing occur in newer lesions and itching can be mild to severe.

Coal-tar salves can help relieve symptoms of nummular dermatitis that have not responded to other treatments, but these ointments have an unpleasant odor and stain clothing. Antibiotics are important if the dermatitis is weeping, sticky or crusted. Sometimes nummular dermatitis clears completely on oral antibiotics, only to recur when they are discontinued.