How to Tell the Difference Between Nummular Eczema and Ringworm
It’s often difficult to distinguish between nummular eczema and ringworm, so it’s always best to be evaluated by a dermatologist, say experts.
Published On: Mar 6, 2023
Last Updated On: Mar 6, 2023
You probably already know that inflammation is part of the body’s immune system and helps you to fight off infections and heal from injuries. But did you know there are actually three types of inflammation?
Broadly, type 1 inflammation works to rid your body of unwanted microbes invading the insides of your cells, while type 2 inflammation works to protect you against parasites (like — ick — worms) and type 3 fights bacteria and fungi that are trying to set up shop outside of your cells.
Sometimes this is exactly what your body needs (i.e., no thank you worms.) However, in other instances — like with eczema — inflammation can be excessive or erratic, potentially causing lasting changes to the immune system and leading to inflammatory disease. If, for example, type 2 inflammation becomes triggered unnecessarily and overreacts to things that aren’t infectious — like pollen, pet dander or dust — it can generate systemic effects (effects all over the body) that weaken the protective epithelial barrier of the skin, mouth, nose and gastrointestinal system.
During a type 2 inflammatory response, the body releases proteins called cytokines and generates antibodies and other immune cells. Together these contribute to allergic reactions like mucus secretion, skin itchiness and redness and more. The cytokines known as interleukins 4 and 13 are, in particular, are key drivers of inflammation and linked to debilitating itch, skin barrier deficiencies and increased risk of skin infections.
How do you know if you have a type 2 inflammation problem? At the moment, there’s not a great diagnostic tool for this, but chances are if you have difficult-to-treat eczema, type 2 inflammation may be at play. According to the Asthma & Allergy Network, 80% of those with atopic dermatitis also have type 2 inflammation occurring in their bodies.1
The key takeaway is that, often behind eczema, there is a complex, multifaceted, chronic inflammatory process at work. A mixture of cells are involved, and you’re not alone in having to deal with this. Many cases of eczema, asthma, nasal polyps, as well as gastrointestinal issues are linked to type 2 inflammation.
The good news is that new treatments are designed to target segments of the type 2 inflammation pathway. Most work by blocking the immune signaling molecules that kick start type 2 inflammation.
Dr. Jeff Yu, board-certified dermatologist at Massachusetts General Hospital, said, “We’ve identified that type 2 inflammation is largely the driver of atopic dermatitis, and now FDA-approved treatments can target signaling molecules within this pathway to stop them and decrease type 2 inflammation. We’ve seen incredible responses to these treatments in patients with atopic dermatitis.”
If you think your eczema regimen isn’t managing your symptoms, and if redness, itchiness and flares are decreasing your quality of life despite your best efforts to avoid triggers and a conscientious bathing and moisturizing routine, talk to your healthcare provider about whether a systemic inflammation-focused treatment may be right for you. As always, there are pros and cons to any treatment, but given that there are more options than ever and more are in development, finding the right balance is hopefully going to get easier and easier.
References:
It’s often difficult to distinguish between nummular eczema and ringworm, so it’s always best to be evaluated by a dermatologist, say experts.
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