Nummular eczema or nummular dermatitis is a chronic, itchy rash which appears in coin shaped patches on the skin. It gets its name from the Latin word for coin, nummular.

The patches are a solid red in early stages, but progress and in later stages will have a clear center, making them resemble either ringworm or a form of psoriasis. If you have nummular eczema you will experience flare ups and remissions.

Other names for this skin disease include: nummular eczematous dermatitis (the scientific name) and discoid eczema (due to the coin shaped lesions). This form of eczema should not be confused with Atopic Dermatitis, which is more common with allergies and is the form most people are speaking about when they use the word eczema.

Although this disease is sometimes an allergy to a medication, the general cause is not known. Associated with dry skin, patients are more often affected in the winter than any other time of the year. Rough clothing, bathing too frequently, harsh soaps, perfumes/dyes, fabric softeners, and hot water irritate the flare up.

Extreme temperature changes and allergies can also aggravate the disease. Certain bacterial infections may also play a part in nummular eczema.

This condition begins with one or several lesions made up of tiny blisters and red spots which combine, forming an itching, red coin shaped lesion which may or may not have a burning sensation. New lesions will drain a pus like fluid which forms a crust as it dries and chronic lesions will appear scaly.

You may have a flare up for less than a year or it may persist for many years. Recurrence is a probability with this disease and tends to appear in the same place as the initial manifestation. Arms, legs, hands and torso are the most common places for nummular eczema to occur and men (usually between the ages 55 to 65) see it more often than women (usually between the ages 15 to 25) do.

There is no known cure for nummular eczema at this time. Topical medications known as corticosteroids remain the most common treatment but more severe cases may be treated by phototherapy, which is a specialized UV treatment through lasers or sunlamps.

Corticosteroids should be used exactly as directed as too few applications will not be of much benefit but too many applications will result in thinned skin. Stronger prescriptions should not be used on the armpits, face, groin, or rectal area. These are generally applied once daily, which is no less effective than multiple applications in most cases. Other possibilities concerning treatment include:

Chronic cases may have coal tart added to the ointment by the pharmacist, this can stain clothing and has an unpleasant odor, but it can be helpful.

During flare ups, you are more susceptible to staph infections and may have to take an antibiotic for a week or two.

Severe cases may need systemic treatments, which are oral or injected medications. Side effects from these tend to be more prevalent than those of other treatments.

By making some changes to your normal care routines, you can minimize the flare ups associated with nummular eczema. Things you can do at home to minimize flare ups and irritation during flare ups include:

Bath regularly but not too frequently using warm, not hot, water and a very mild soap. Ivory soap is usually acceptable. If taking a bath, perfume free/dye free oil additives can be helpful.

Moisturize well after bathing or washing the hands using a cream or petroleum jelly based moisturizer on wet skin. You also need to moisturize throughout the day as the need arises. Lotions are not recommended.

Pat excess water from skin after moisturizing, rubbing not only removes moisturizer, but irritates the skin.

Cotton clothing is recommended. Avoid the use of detergents, fabric softeners, and dryer sheets with perfumes and/or dyes. Dreft (made for babies) is an excellent detergent for this.