Eczema: discoid (syn. nummular) eczema

Patient Information Leaflet
Link: Eczema - discoid eczema

https://www.pcds.org.uk/patient-info-leaflets/eczema-discoid-eczema

The term discoid eczema comes from its characteristic round or oval 'disc-shaped' patches. For the same reason it is sometimes also called nummular eczema - nummular meaning coin-shaped. The cause of discoid eczema is unknown.

This chapter is set out as follows:

• Age - most commonly presents in middle-aged patients, but can affect any age group 
• Often very itchy
• Can be associated with excessive bathing or swimming

Distribution

• Can occur anywhere although the limbs predominate

Morphology

• Discrete round / oval patches
• Differs from psoriasis in that lesions tend to be a lighter red, the border fades gradually at the periphery and they may have an exudate / crust as opposed to scale 

• Refer to the top right of the page for a patient information leaflet available through a QR code or printable PDF

• Acute treatment - short-term use of a potent topical steroid, eg 0.1% betamethasone cream OD until things settle 

• Long-term treatment - regular use of a topical emollient (prescribe 500 g), at least twice a day, with the same topical steroid reintroduced for a flare. The more emollient used, the less the skin will flare, limiting the use of topical steroids (although it is safe for adults to use approximately 100 g of a potent topical steroid per month if required, bearing in mind applications over areas of thin skin such as the face and shins should be kept to a minimum)  

• For more detailed information on management refer to the related chapter Atopic Eczema, as the management principles are similar