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Nummular Eczema

Nummular eczema (also known as discoid eczema and nummular dermatitis) is a form of eczema that can occur at any age. It looks different than other types of eczema and can be difficult to treat.

This image displays a severe case of nummular dermatitis.

A severe case of nummular dermatitis.

The word “nummular” comes from the Latin word for “coin,” as the spots can look coin-shaped on the skin. The spots may be very itchy or not itchy at all. They can be very dry and scaly or can become wet and open.

The cause of nummular eczema is unknown, but it does not seem to run in families. Sometimes, it will be triggered by such things as:

  • An insect bite
  • A reaction to inflammation (including atopic dermatitis) elsewhere on the body
  • Dry skin in the winter

Because nummular eczema can look like ringworm, it is important to make sure that it is not a fungal infection, especially if it is not responding to treatment. This can usually be done by your doctor with a scraping or a fungal culture.

Nummular Dermatitis - Image:

A round, scaly area that has been eroded by scratching, typical of nummular dermatitis.

Like atopic dermatitis, nummular eczema can get infected by bacteria — usually staphylococcus. Make an appointment with your doctor if you think you have an infection on your skin where the nummular eczema appears.

How is nummular eczema treated?

Like atopic dermatitis, nummular eczema benefits from moisturizers to calm and protect the damaged skin barrier.

In many cases, you may receive a prescription for a steroid medication to calm the inflammation as well. For some reason, the milder and moderate-potency steroid creams may not be of much help with nummular eczema. More powerful creams are frequently required. Fortunately, nummular eczema tends to disappear completely after the right treatment.

In cases where steroids are not appropriate, or when you have used them for a long time, your doctor may prescribe a non-corticosteroid topical medication such as tacrolimus (Protopic) or pimecrolimus (Elidel). These medications are called topical calcineurin inhibitors are approved for use by adults and children two years of age or older.

Topical or oral antibiotics may be used when there is a bacterial infection on the skin.

Oral antihistamines may take away some of the itch of nummular eczema, especially at night.

Nummular Dermatitis - Image:

Round circles typical of nummular dermatitis.

In very severe cases, systemic steroids (taken by mouth or given by injection) may be used for a short time to calm symptoms.

Will nummular eczema ever go away?

Many people, even those who have a severe nummular eczema seem to clear up completely and do not appear to have the long-term issues like other forms of eczema.

View more nummular eczema pictures at