Nummular Eczema

Overview

What is nummular eczema?

Nummular eczema is a skin condition that causes circular, raised spots on your skin. Nummular comes from a Latin word for “coin,” and the patches are coin-shaped. The lesions are often itchy, sometimes ooze clear fluid and may become crusty on top.

The condition is chronic. Patches can last for weeks to months, and flare-ups or episodes can repeatedly happen over a long period of time.

Nummular eczema is also called nummular dermatitis and discoid eczema.

What is the difference: Nummular eczema vs. ringworm?

Ringworm and nummular eczema both cause circular patches on your skin. But the causes and treatments are different.

Ringworm is a contagious skin infection caused by a fungus. Nummular dermatitis is a type of eczema rather than a fungal infection. Ringworm tends to appear as one or two patches on your skin, but nummular eczema often causes multiple patches.

Is nummular eczema a fungus?

Nummular dermatitis isn’t a fungus, and it’s not contagious.

What is the difference: Nummular eczema vs. psoriasis?

It can be difficult to tell the difference between eczema and psoriasis.

Psoriasis tends to cause thick scales on your skin. Nummular eczema causes bumps that may ooze and become crusty. Eczema tends to be itchier than psoriasis.

Who might get nummular eczema?

Discoid eczema (nummular eczema) can affect anyone, but it’s more common among men or people assigned male at birth. It tends to occur in:

  • Women or those assigned female at birth between the ages of 15 to 25 years.
  • Men or those assigned male at birth between the ages of 50 to 65 years.

Symptoms and Causes

What causes nummular eczema?

Scientists aren’t sure why nummular dermatitis occurs, but it may be triggered by:

  • Allergies.
  • Bacterial infection (for example, Staphylococcus).
  • Exposure to rough fabrics (for example, wool).
  • Extremely dry skin or dry environments.
  • Frequent bathing or showering with hot water.
  • Skin trauma or injury, like a burn, scrape or bug bite.
  • Use of irritating and drying soaps.

Is nummular eczema caused by stress?

Although stress doesn’t cause discoid (nummular) eczema directly, some research shows that it can contribute to flare-ups.

What are the symptoms of nummular dermatitis?

Nummular eczema lesions usually appear on your arms, legs, hands or torso. The early signs are tiny bumps or blisters. The bumps may join together into a coin-like shape. They often leak clear fluid and become crusty on top.

Nummular dermatitis spots tend to be intensely itchy. Your skin may burn or sting.

The color of the lesions may vary, depending on your skin tone. They may be pink, red or brown. They can be lighter than your skin or darker.

Is discoid eczema contagious?

Nummular eczema isn’t contagious. You can’t spread it to other people, and it won’t spread on your own body, but you may get additional patches in other areas.

Diagnosis and Tests

How is nummular eczema diagnosed?

For diagnosis, consider visiting a dermatologist, who specializes in skin conditions. They can tell the difference between ringworm, nummular dermatitis, psoriasis, additional types of eczema and other skin conditions.

Your healthcare provider can usually diagnose nummular eczema by examining your skin. Tests are generally not necessary, but sometimes, a healthcare provider will scrape your skin and look at it under a microscope.

Management and Treatment

Is there a cure for nummular eczema?

There’s no cure for this condition. Treatment aims to:

  • Clear or prevent infection.
  • Ease symptoms.
  • Restore the natural skin barrier.
  • Teach good skincare to prevent future flare-ups.

How do you get rid of nummular eczema?

To help clear nummular dermatitis flare-ups, your healthcare provider may prescribe topical treatments. These creams or ointments are applied to your skin:

Some people with broad areas of discoid eczema have difficulty covering all spots with topical treatments. Healthcare providers may suggest ultraviolet light therapy two to three times per week or oral corticosteroids.

Researchers continue to study additional treatment options.

Prevention

How can I prevent nummular eczema episodes?

To reduce your risk of discoid eczema flare-ups, try these skincare strategies:

  • Avoid skin products and laundry detergents that contain fragrances or dyes.
  • Avoid tight clothing and irritating fabrics.
  • Manage stress, which may contribute to flare-ups.
  • Moisturize with thick products, such as petroleum jelly or hydrating cream, especially when the skin is still damp after bathing or showering.
  • Prevent skin injury. If an injury occurs, clean the area and cover it with a bandage.
  • Take short (five-minute), lukewarm showers.
  • Avoid hot long baths.
  • Use gentle cleansers that contain moisturizers.
  • Avoid rubbing exfoliating skin.
  • Avoid using a washcloth, buff puff or loofah.

Outlook / Prognosis

What can I expect if I have nummular dermatitis?

With correct diagnosis, treatment and self-care, nummular eczema usually clears up.

The nummular eczema healing process usually takes one to several weeks. The spots will flatten, get lighter in the middle and disappear.

Does discoid eczema usually return after treatment?

Nummular eczema is a chronic condition, which means you can have additional episodes after successful treatment. You may experience flare-ups every few months or years.

Living With

How do I take care of myself with nummular eczema?

To ease the symptoms of nummular dermatitis at home, use the prevention tips above. Also:

  • Avoid scratching the spots, as that can cause infections and scars.
  • Cover lesions with a moist bandage (for example, a band-aid with petroleum jelly on the pad).
  • Follow your healthcare provider’s instructions carefully.
  • Take an antihistamine, such as hydroxyzine or diphenhydramine, to reduce itchiness and help you sleep at night.

When should I call my healthcare provider about nummular dermatitis?

If you have nummular eczema, you should talk to a healthcare provider and receive treatment. They can help you clear the flare-up more quickly and prevent infection.

During treatment, call for any signs of infection, such as:

  • Feelings of pain or tenderness on or near affected areas.
  • Red or brown streaks on the skin near a lesion.
  • Swelling.
  • Yellow or gold fluid or crust on the lesions, indicating the presence of pus.

A note from Cleveland Clinic

Nummular eczema is a skin condition that causes raised, coin-shaped lesions on your skin. If you have any unusual spots on your skin, talk to a healthcare provider such as a dermatologist. They can differentiate between fungal infections such as ringworm, chronic problems such as eczema and other skin conditions.

Last reviewed by a Cleveland Clinic medical professional on 04/19/2022.

References

  • American Academy of Dermatology Association. Eczema Types: Nummular Eczema Signs & Symptoms. (https://www.aad.org/public/diseases/eczema/types/nummular-dermatitis/symptoms) Accessed 4/19/2022.
  • National Eczema Association. Nummular Eczema. (https://nationaleczema.org/eczema/types-of-eczema/nummular-eczema) Accessed 4/19/2022.
  • Robinson CA, Love LW, Farci F. Nummular Dermatitis. (https://www.ncbi.nlm.nih.gov/books/NBK565878/) [Updated 4 Jan 2022]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Accessed 4/19/2022.

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