Nummular dermatitis in Adult
Alerts and Notices
SynopsisNummular dermatitis (nummular eczema) is a particular form of dermatitis characterized by pruritic, coin-shaped, scaly plaques. It is of uncertain etiology, but the onset is associated with triggers such as frequent bathing, low humidity, irritating and drying soaps, skin trauma, interferon therapy for hepatitis C, and exposure to irritating fabrics such as wool. Venous stasis may be a predisposing factor to developing lesions on the legs. Many authorities consider it to be a form of eczema, and some patients often have some of the signs and symptoms associated with classic atopic dermatitis. However, a majority of individuals with nummular dermatitis do not have a personal or family history of atopy. Infectious etiologies, particularly respiratory and dental infections, have been investigated but this association remains unclear. Ultimately, the etiology of nummular dermatitis remains incompletely elucidated.
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.
L30.0 – Nummular dermatitis
81418003 – Nummular dermatitis
Differential Diagnosis & Pitfalls
- Allergic contact dermatitis
- Irritant contact dermatitis
- Tinea corporis
- 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
- Mycosis fungoides
- Glucagonoma syndrome
- Eczema craquele
- Crusted scabies (with severe immunosuppression)
Drug Reaction DataBelow 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.
Patient Information for Nummular dermatitis in Adult
OverviewNummular 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 RiskNummular dermatitis may affect people of all ages.
Signs & SymptomsNummular 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 GuidelinesMaintaining 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 CareYou should seek medical care if there is a lack of response to self-care measures or the condition worsens or flares.
TreatmentsYour 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.
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