What Is Nummular Eczema (Discoid Eczema)?

In my youth, I liked collecting coins, and in college learned that the fancy word for a coin collector (and I don’t mean bitcoin) is a “numismatist.” So when I entered the pediatric residency and learned about Nummular Eczema, I felt pretty cool knowing that nummular Eczema probably had something to do with coins.

What Is Nummular Eczema (Discoid Eczema)?

So with nummular eczema also known as nummular dermatitis or discoid eczema, is a common type of eczema, you get round lesions that pop up in seemingly random places that are quite itchy and can be covered in crusts. Many people affected by this condition come to the office concerned that they have ringworm.

It can be an acute or chronic skin condition that causes circular raised rashes and spots on the skin which is why it is often confused with ringworm or psoriasis. If it is an acute condition, this means it will go away within a few weeks or months forever or if it is chronic it will come and go over the years showing up again as an eczema flare-up.

Nummular Eczema Pictures

Nummular Eczema (Nummular Dermatitis) Causes

The exact cause of nummular eczema is unknown but likely has to do with skin barrier dysfunction which can lead one to have an over-exuberant inflammatory response to any number of environmental irritants.

According to the American Academy Of Dermatology, some of the common factors that trigger nummular eczema and its flare-ups are:

• Dry air
• Stress
• Heat
• Humidity
• Injury
• Skin infection
• Dry skin
• Certain medication
• Alcohol consumption
• Chemicals in skincare products.

People who have a family or personal health history of atopic dermatitis, contact dermatitis, asthma, and allergies are more likely to develop it. 

Nummular Eczema Symptoms

Itching is the most prominent symptom of nummular eczema like it is with any other type of eczema. Discoid eczema usually causes bumps and blisters on the arms, legs, hands, and torso.

These blisters are mostly coin-shaped and leak clear fluid that becomes crusty. Some of the other common symptoms are:

• Intense itching
• Burning sensation
• Inflamed skin
• Redness 

Is Discoid Eczema Contagious?

Discoid eczema like any other eczema is not contagious and can not spread to others from touching or coming in contact with. You may experience it on other parts of your body but it is not because it’s contagious.

Nummular Eczema VS Ringworm

Distinguishing between ringworm and Nummular Eczema requires a trained eye because these lesions can have “central clearing” similar to ringworm.

According to Medscape, ringworm usually has few vesicles, a raised narrow border, and a leading scale (that is, scale on the outside of the plaque).

According to Paller (2006), lesions usually occur on the outsides of the hands, arms, and legs and can occasionally happen on the face and trunk.

Ringworm is a skin infection caused by fungus and is contagious. However, nummular eczema is a chronic condition and a type of eczema and is not contagious.

Ringworm usually causes a few circular patches on the skin whereas discoid eczema causes multiple patches.

It is best to consult a dermatologist as they will be able to properly diagnose the condition.

Nummular Eczema Treatment

Even though there is no permanent cure for nummular eczema, it can be managed by following a few simple steps:

• Bathe daily with a gentle irritant-free cleanser
• Moisturize with an irritant-free eczema cream at least twice daily.
• Use products in your laundry that avoid scent and color.
• Avoid skincare products that contain harsh chemicals.
• Make the bathtime short (5-10 minutes) and use lukewarm water instead of hot water.
• Moisturize the skin immediately after taking a bath.
• Avoid wearing tight clothing and irritating fabrics.
• For severe cases consult a dermatologist they may prescribe topical corticosteroids, oral antistaphylococcal antibiotics, and topical calcineurin inhibitors.

Nummular Eczema and Happy Cappy

Happy Cappy products are made for people with sensitive skin conditions like Nummular Eczema. Eczematous skin can have a higher pH than normal skin which has a low pH (4-5). Regular old soaps tend to have high pHs. Using a soap that also has a low pH (like normal skin) can help normalize the pH of irritated skin and improve skin barrier function. 

Furthermore, these are infused with redness soothing Licorice Root Extract and Glycerin which helps draw moisture into the skin. 

Happy Cappy Daily Shampoo & Body Wash for eczema has the low pH you need and avoids agents that dry out skin like sulfates and irritants like fragrances and preservatives like parabens that can aggravate already broken skin.

Happy Cappy Moisturizing Cream for Eczema acts as a thick emollient and avoids common skin irritants, locks in moisture, and protects and restores the skin barrier. 

Some competing products use dimethicone or mineral oil to accomplish this which can make the skin feel greasy or slippery. 

Happy Cappy’s formulation avoids those two ingredients and instead opts for pharmaceutical grade white petrolatum in a proprietary formulation with glycerin and other smoothing emulsifiers resulting in a non-greasy, non-sticky, eczema cream that will not sting irritated skin.

References:

1. Miller, Jami. “Nummular Dermatitis (Nummular Eczema).” Medscape. Updated: Nov 21, 2019. https://emedicine.medscape.com/article/1123605-overview#a5 .Accessed 29 June 2020.
2. Paller, Amy and Anthony Mancini. Hurwitz Clinical Pediatric Dermatology. Third Edition. Elsevier Inc. 2006.

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Dr. Eddie Valenzuela

Dr. Eddie Valenzuela is an award winning pediatrician and the founder and CEO of Pediatric Solutions, LLC.

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