What is Nummular Eczema

By Dr. Eddie Valenzuela

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. “Nummular” in Latin means “coin-like.”

So with nummular eczema (also known as nummular dermatitis), 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.

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) [1].

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 [2].

What is the cause of nummular eczema?

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.

What is the management of Nummular Eczema?

The management is similar to what one would do with atopic dermatitis –eczema:

• Bathe daily with a gentle irritant-free cleanser
• Moisturize with an irritant-free emollient at least twice daily.
• Use products in your laundry that avoid scent and color.
• You will most likely need to see your healthcare provider to get prescription steroids, and in severe cases may require oral medications.

Nummular Eczema and Happy Cappy

Happy Cappy was made for people with sensitive skin conditions like Nummular Eczema. Skin that is eczematous 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, Happy Cappy products 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 avoids irritants like fragrance and preservatives like parabens that can aggravate already broken skin.

Happy Cappy developed a moisturizing baby eczema cream that acts as a thick emollient that also avoids common skin irritants and 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 white petrolatum in a proprietary formulation with glycerin and other smoothing emulsifiers resulting in a non-greasy, non-sticky, baby eczema cream that will not sting.

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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