Nummular Dermatitis, Causes, Diagnosis, Treatment, Prevention, Complications
Discoid eczema or nummular dermatitis is a chronic skin disorder that causes circular, coin-like patches to appear. These patches itch and have a rough surface, but are not contagious.
Nummular dermatitis usually appears after an injury to the surface of the skin, such as a burn, scrape, or insect bite. This disorder can last for weeks, months, even years, and can recur.
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| Nummular Dermatitis, Causes, Diagnosis, Treatment, Prevention, Complications |
Although it appears more frequently on the legs, discoid eczema can occur anywhere on the body. Nummular dermatitis is more common in men aged 55–65 years.
Causes of Nummular Dermatitis
The exact cause of nummular dermatitis is not known. Even so, most cases of nummular dermatitis are thought to occur due to sufferers having very dry skin conditions (xerosis) and being sensitive to a number of certain substances, such as:
- Metals, including nickel and mercury
- Formaldehyde or formalin, which is widely used in the manufacture of building materials and household products, for example for the manufacture of glue, coatings or fabrics
- Medications, especially antibiotics applied to the skin, such as neomycin
In addition to the several conditions above, a number of the following risk factors also make a person more susceptible to nummular dermatitis:
- Are male and over 50 years old
- Have sensitive skin that is easily irritated due to the use of cleaning products, cosmetics or clothing with rough textures
- Suffer or have a family member with a history of allergies, asthma, or atopic dermatitis
- Have a condition that causes restricted blood circulation, especially in the legs, such as varicose veins and diabetes
- Experiencing minor skin injuries, such as insect bites, burns, or sharp object scratches
- Taking certain drugs, such as isotretinoin, interferon, or statin group cholesterol drugs
- Residing in dry or cold climates
In addition, stress and changes in air temperature due to exposure to hot sun or cold wind can also trigger nummular dermatitis.
Symptoms of Nummular Dermatitis
The main symptom of nummular dermatitis is raised patches (patches) on the surface of the skin. These spots are coin-shaped with a rough, brownish or reddish texture. In some cases, the center of the patch can appear clean, making it look like ringworm.
Before becoming raised spots, nummular dermatitis begins with the appearance of small reddish spots on the skin. These spots then merge into larger circles (spots). These patches can swell, blister, and ooze.
Nummular dermatitis patches will sting like burning and be very itchy, especially at night. Most sufferers feel the appearance of several spots and only a small proportion find one spot.
Discoid eczema, also known as discoid dermatitis, can occur anywhere on the body. However, this dermatitis appears more often on the legs. Meanwhile, the parts that rarely experience discoid eczema are the face and scalp.
Discoid eczema that is left unchecked can cause a bacterial infection. This situation can be characterized by a number of the following symptoms:
- Spots change color to yellow
- Lots of fluid coming out of the spots
- Inflamed skin around the spot (swelling, heat, and pain)
- feverish
When to see a doctor
Check with your doctor if you experience the symptoms of nummular dermatitis mentioned above. A doctor's examination is needed so that this disorder can be treated as early as possible and to prevent complications.
Take periodic employee medical check-ups provided by the company, if the job has a high risk of exposing you to chemicals, such as formaldehyde or mercury.
Diagnosis of Nummular Dermatitis
The doctor will ask about the patient's complaints and symptoms, and trace the history of the disease that the patient and his family have had. After that, the doctor will carry out a physical examination by observing the skin area that has nummular dermatitis.
In some cases, these tests are sufficient to determine the diagnosis and treatment. However, often the symptoms of nummular dermatitis are similar to other skin diseases, such as ringworm, proriasis, or contact dermatitis, so it needs to be confirmed with another examination because the treatment is different.
A number of supporting examinations that can be carried out to confirm the diagnosis of skin disorders that occur are:
- Scrape the skin
- This examination is done by scraping the surface of the skin affected by dermatitis to see the presence of fungus. The goal is to differentiate this disease from ringworm.
- Patch allergy test (patch testing)
- The trick is to attach some substance to the skin, such as nickel metal. Allergy testing is done if the patient is suspected of having an allergy.
- Skin biopsy
- Skin biopsy examination is carried out by taking a small sample of skin tissue from the area that has abnormalities, to then be examined under The aim is to see skin abnormalities that occur.
Treatment of Nummular Dermatitis
Treatment for nummular dermatitis aims to relieve symptoms and keep them under control. This can be done with the following treatment methods:
Self care
Patients can take care independently to reduce symptoms and speed up treatment. The trick is to:
- Do not wear clothes with materials that can trigger allergies, such as wool or knitwear
- Avoiding exposure to substances that can trigger dermatitis, for example by not using soaps that contain perfumes, detergents, or fragrances and fabric softeners
- Wearing gloves when in contact with substances or materials that can cause irritation, such as household cleaning products
- Applying a skin moisturizer or emollient to dry skin areas
- Do not shower or soak for too long, especially when using warm water
- Manage stress well, for example with meditation or yoga
Drugs
Some drugs to treat nummular dermatitis can only be obtained with a doctor's prescription. These drugs are:
Corticosteroids
Topical corticosteroids are the drugs most often used to treat nummular dermatitis. This drug works to relieve inflammation and reduce irritation in the spotting area. Corticosteroids in tablet or injection form can also be given in more severe cases.
Antihistamine
Antihistamines (allergy itching medications), such as cetirizine, can relieve itching and discomfort on the skin.
Antibiotics
Antibiotics, such as erythromycin, may be given if infection also occurs. This drug can stop the growth of bacteria that cause infection.
Other drugs, such as methotrexate, azathioprine, or ciclosporin, may also be given. However, these drugs can cause serious side effects, so their use needs to be monitored by a dermatologist.
Ultraviolet (UV) radiation therapy
Treatment with UV light can be done if discoid eczema is severe enough and therapy with drugs does not give maximum results. This therapy is performed several times a week, for 2–3 months, to reduce the severity of symptoms and speed healing.
Discoid eczema can generally be controlled with a number of the above treatments, but the potential for recurrence remains. In most sufferers, these patches of nummular dermatitis can completely disappear without leaving a mark on the skin.
Even so, in some people, these spots can cause scars in the form of changes in skin color.
Nummular Dermatitis Complications
There are several complications that can arise due to nummular dermatitis, including:
- Bacterial infection
- Permanent skin discoloration in areas of dermatitis
- Sleep disturbance and difficulty concentrating
- Permanent scars on areas of dermatitis
- Cellulitis
Nummular Dermatitis Prevention
Nummular dermatitis can be prevented by avoiding triggers. The way to do this is:
- Keeping the skin always hydrated, for example diligently applying moisturizer, especially after bathing
- Using cosmetic products or cleaning products that are gentle and do not have the potential to irritate or dry out the skin
- Do not bathe or soak in water for too long, especially in warm water
- Wear loose clothing with materials that absorb sweat, such as cotton
- Comply with work safety rules and standards, especially in work areas with lots of chemicals
- Manage stress well, for example with meditation or yoga
- Living a healthy lifestyle, namely by adopting a balanced nutritious diet and exercising regularly
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