Nummular dermatitis in Adult
Alerts and Notices
Synopsis
Nummular dermatitis is pruritic but may be less pruritic than other common diagnoses with scaly plaques (eg, tinea). Autoeczematization (widespread eczematous eruption secondary to triggers such as infection or severe localized eczema) and impetiginization (superinfection of impaired skin barrier) may be seen. Nummular dermatitis is most common in men, and the peak age of incidence is between 50 and 65 years. The second most common age range of incidence is 15-25 years.
Codes
ICD10CM:L30.0 – Nummular dermatitis
SNOMEDCT:
81418003 – Nummular dermatitis
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
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.
- Majocchi granuloma
- Lichen simplex chronicus
- Ichthyosis vulgaris
- Small plaque parapsoriasis
- Pityriasis rubra pilaris
- Secondary syphilis
- Pellagra
- Mycosis fungoides
- Glucagonoma syndrome
- Eczema craquele
- Crusted scabies (with severe immunosuppression)
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
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
Subscription Required
Last Reviewed:01/31/2017
Last Updated:03/28/2017
Last Updated:03/28/2017
Patient Information for Nummular dermatitis in Adult
Overview
Nummular dermatitis is a particular form of eczema (atopic dermatitis) characterized by coin-shaped, raised areas on the skin that are scaly.- The cause of nummular dermatitis is not known, but it is associated with triggers such as frequent bathing, irritating and drying soaps, and exposure to irritating fabrics such as wool.
- Those with nummular dermatitis often have some of the signs and symptoms typically associated with eczema.
- Nummular dermatitis is itchy (pruritic), but it is less itchy than other common diagnoses with scaly plaques, such as psoriasis.
- Winter is usually the time of onset and severity.
- Nummular dermatitis can be chronic, and symptoms can go away and recur indefinitely.
Who’s At Risk
Nummular dermatitis may affect people of all ages.Signs & Symptoms
Nummular dermatitis is most commonly found on the trunk and/or extremities. Round or coin-shaped, pink to red, scaly, raised areas are seen, often with small cracks or superficial breaks in the skin located within.Self-Care Guidelines
Maintaining healthy skin is very important for sufferers of nummular dermatitis.- Moisturizing skin-care routines are essential.
- Non-soap cleansers, such as Cetaphil, or moisturizing soaps, such as Dove, are recommended.
- Thick moisturizers such as petroleum jelly, Aquaphor ointment, Eucerin cream, CeraVe cream, and Cetaphil cream should be applied to damp skin daily after bathing.
- Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress.
- Fragrance-free laundry detergent may be beneficial.
- Keep the home humid with a humidifier or setting out bowls of water, especially in the bedroom.
When to Seek Medical Care
You should seek medical care if there is a lack of response to self-care measures or the condition worsens or flares.Treatments
Your physician may:- Prescribe medium- to high-potency topical steroids to apply to the affected areas twice daily.
- Recommend light therapy with ultraviolet B for extensive disease.
- Prescribe oral antihistamines to help relieve itching.
- Prescribe oral or topical antibiotics if the area becomes infected.
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 Adult