Symptoms
Nummular eczema (from Latin , coin) is an inflammatory skin disease that manifests itself in sharply defined, coin-shaped rashes that primarily affect the extensor sides of the legs, arms, and trunk. The areas are weeping, inflamed (reddened), and may become dry, crusted, and itchy. Unlike cutaneous fungus, the lesions are filled in and do not enlarge. The course is often chronic or chronic-recurrent for months to years.
Causes
The exact causes have not been fully elucidated. Discussed causes include:
- Environmental factors (irritants, climate).
- Diet
- Dry skin
- Bacterial pathogens such as , also as superinfection.
- Allergies, allergies to bacterial antigens.
- Stress
- Medications such as gold and isotretinoin
- Stimulants: alcohol (heavy consumption)
A tendency to hypersensitivity reactions (atopy) in the family history is a risk.
Diagnosis
The diagnosis is made in medical treatment based on the clinical picture. Other possible causes must be excluded, for example, fungal skin infections.
Nonpharmacologic treatment
- Use a mild soap.
- Do not dry out the skin: do not bathe or shower too often. Do not use too hot water.
- Avoid irritants and allergens.
- Do not scratch to prevent the development of superinfection.
- Apply cold compresses.
Drug treatment
Medications available for drug treatment include the following. Not all of them are suitable for children: Skin care products soften and smooth the skin, add lipids and water, and strengthen the skin barrier. Topical glucocorticoids (“cortisone ointments“) have anti-inflammatory, anti-allergic and anti-pruritic properties. They should not be applied over too long a period, over large areas, or under occlusion to prevent adverse effects. Anti-pruritic agents such as antihistamines, menthol, camphor, polidocanol, and zinc oxide can symptomatically relieve symptoms but usually have no effect on the course of the disease. Immunosuppressants such as topical calcineurin inhibitors are another treatment option. Cardiospermum is widely used, especially in alternative medicine, to treat eczema. It is mainly applied locally as an ointment. Cardiospermum ointments are better tolerated than topical glucocorticoids.
