People with nummular eczema, also called discoid eczema or nummular dermatitis, deal with inflamed skin and rashes that resemble coin-shaped discs or plaques and appear mostly on the lower legs, forearms, hands, and trunk. Typically, discoid eczema does not develop on the face or scalp. The most common symptom of this condition is itchiness that can reach a level of extreme discomfort. Eczema is not contagious but is generally a chronic condition. In women, dermatitis usually develops in the teens or young adulthood, while men tend to develop it later in life.
The difference between discoid eczema and skin infections can be difficult to identify. People with eczema have up to 50 round or oval raised plaques with well-defined edges. Some might have scales or a yellowish crust. If the patches are a skin infection, people will generally see blisters filled with pus, sores that look like cold sores, and streaks of redness spreading across the skin. Infections also come with other symptoms like a fever, pain, flu-like symptoms or swollen lymph nodes or tonsils. Eczema does not.
Itchiness is a major symptom of discoid or any other form of eczema, and the issue can interrupt sleep and daily activities. Some people may also experience burning or stinging. Most doctors give eczema patients a strong warning against scratching, as it can cause infection, more redness and irritation, and more itching. Additionally, constant scratching can permanently change the texture of the skin and can lead to lichenification, which makes the outer layer of skin overgrown, thick, and leathery. Scratching also increases the risk of scarring.
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Pus is a clear sign of infection. The secretion may be white, brown, or yellowish and is a natural sign of the body trying to fight infection. Uninfected nummular eczema will not seep; when it does, this indicates a buildup of dead white blood cells. An accumulation of pus in an enclosed tissue space over time can develop into an abscess, which can spread internally and infect the bloodstream. Pus or weeping bump sites in eczema are usually a sign of staphylococcal or bacterial, infection. Eventually, these infections dry up and develop scales.
The most common form of eczema is atopic, which often develops in childhood. It makes the skin red, itchy, dry and cracked. Some people outgrow this condition by early adulthood, but it may also be a chronic issue. Atopic eczema expresses differently in different people. Some develop small patches, while others have red, inflamed skin across the entire body. Most often, atopic eczema affects the hands, elbows, and insides of elbows and knees. In children, it can show up on the face and scalp.
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Some people with discoid eczema have stasis dermatitis, which makes the initial condition worse. Statis dermatitis affects mostly adults who have an existing circulation problem and a challenge getting blood flow to the lower legs. Improper blood flow damages the skin which, even in healthy individuals, only receives 1.7 percent of the blood flow from the heart. This is already less oxygen than other organs and tissues receive. Poor circulation weakens the skin's natural defenses that fight eczema.
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Winter strips the skin of natural moisture. The heat used to warm our homes sucks the moisture from the air, which in turn takes moisture from the skin. Hot showers deplete the skin of even more moisture and natural oils, leaving the outer layer feeling dry and itchy, even in people without eczema. People with nummular dermatitis must take extra precautions to preserve moisture.
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Sometimes, an occlusive bandage is an effective treatment for nummular eczema, especially if you apply them at night when you sleep. This air- and water-tight dressing with a waxy coating completely seals the area and protects it from bacteria, dry air and wind, and other factors that can aggravate eczema.
Bathing in lukewarm rather than hot water can help people with discoid eczema maintain those essential oils that moisturize the skin. Applying quality lotion or cream immediately after a shower or bath will also help in this regard. Avoid petroleum-based ingredients and chemicals that make the skin drier in the long run. Drink liberal amounts of water, especially in winter when people tend to turn to hot beverages rather than pure, refreshing and replenishing water.
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Most often, your doctor will not recommend steroid injections for nummular dermatitis unless all other approaches have failed. In some cases, steroids are most effective if the area has developed lesions and the spread of eczema has persisted for some time. This is not a long-term treatment, however. The side effects of prolonged use of these injections have led medical practitioners to use them sparingly.
Home remedies can help people with discoid or nummular eczema and dermatitis cope with flare-ups. The most effective approach for chronic eczema lies in knowing how your body responds to remedies that treat inflammation and guard against infection. For example, tar preparations have been effective in reducing inflammation for skin that has older rashes and is already scaly with plaques. Some people turn to herbal remedies, aromatherapy, and homeopathy, as well.
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