Nummular dermatitis in Child
Alerts and Notices
Synopsis
Winter is usually the time of onset and exacerbation. Nummular dermatitis can be chronic with a waxing and waning course.
Some experts consider childhood nummular dermatitis as a subtype of atopic dermatitis.
Codes
ICD10CM:L30.0 – Nummular dermatitis
SNOMEDCT:
81418003 – Nummular dermatitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Allergic contact dermatitis
- Irritant contact dermatitis
- Tinea corporis
- Psoriasis
- Pityriasis rosea
- Seborrheic dermatitis – The distribution of lesions is often a helpful clue in distinguishing this entity from atopic dermatitis.
- Lichen simplex chronicus
- Ichthyosis vulgaris
- Scabies
- Fixed drug eruption
- Secondary syphilis
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:01/31/2017
Last Updated:03/28/2017
Last Updated:03/28/2017
Patient Information for Nummular dermatitis in Child
Overview
Nummular dermatitis is a type of inflammatory skin condition (eczema) that appears as coin-shaped sheets of scaly skin.- The cause of nummular dermatitis is not certain, but the condition may be triggered by frequent bathing, use of irritating and drying soaps, and exposure to irritating fabrics such as wool.
- People often show the same signs and symptoms that occur with eczema.
- Nummular dermatitis is an itchy rash that can be severe, and affected children can be irritable.
- It usually occurs in the winter and often becomes worse at that time.
- Nummular dermatitis can be long-lasting (chronic) with periods when it is worse alternating with periods of improvement (a waxing and waning course).
Who’s At Risk
Nummular dermatitis may affect people of all ages, but it is most common in older men.Signs & Symptoms
Nummular dermatitis is most commonly found on the trunk and/or the arms and legs. Round or coin-shaped, pink-to-red sheets of surface skin (plaques) appear, often with small cracks (fissures) or breaks in the surface skin inside the affected area.Self-Care Guidelines
The most important self-care measure for treating nummular dermatitis is to keep the skin moist. Help your child try the following:- Non-soap cleansers such as Cetaphil or moisturizing soaps such as Dove.
- Thick moisturizers such as petroleum jelly (Vaseline), Aquaphor ointment, Eucerin cream, CeraVe cream, or Cetaphil cream, applied to damp skin after daily bathing.
- Measures to reduce exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress.
- Fragrance-free laundry detergent.
- Keep your home humid with a humidifier or by setting out bowls of water, especially in the bedroom.
- Over-the-counter 1% hydrocortisone cream twice daily or lotions with menthol and phenol (Sarna lotion) to relieve itching.
When to Seek Medical Care
See your child's doctor or a dermatologist if you see no improvement with self-care measures or if the condition gets worse.Treatments
Your physician may:- Recommend the above self-care measures.
- Prescribe medium- to high-potency topical steroids to apply to the affected areas twice daily.
- Prescribe oral antihistamines to help relieve itching.
- Prescribe oral or topical antibiotics if an infection is suspected.
References
Bolognia, Jean L., ed. Dermatology, pp.218-223. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed., pp.1194-1196. New York: McGraw-Hill, 2003.
Nummular dermatitis in Child