Discoid eczema or nummular dermatitis is a chronic skin disorder that causes circular, coin-like patches to appear. These patches are itchy and have a rough surface, but are not contagious.
Nummular dermatitis (nummular dermatitis) usually appears after damage to the surface of the skin, such as burns, friction, or insect bites. This disorder can last for several weeks, months, even years, and can recur.
Although it is more common in the legs, discoid eczema can occur anywhere on the body. Nummular dermatitis is more common in men aged 55-65 years.
Numular Dermatitis Symptoms
The main symptom of nummular dermatitis is patches that appear on the surface of the skin. These patches are shaped like coins with a rough texture, brown or reddish in color. In some cases, the center of the spot can look clean, giving it the appearance of ringworm.
Before becoming patches as described above, nummular dermatitis begins with the appearance of small red spots on the skin. These spots then merge into larger circles (spots). These patches may swell, blister, and ooze fluid.
Patches of nummular dermatitis will sting like burning and be very itchy, especially at night. Most sufferers feel the appearance of several spots and only a small number find one spot.
Discoid eczema, also known as discoid dermatitis, can occur anywhere on the body. However, this dermatitis is more common on the legs. While the parts that rarely experience discoid eczema are the face and scalp.
Discoid eczema that is left untreated can lead to a bacterial infection. This condition can be characterized by a number of symptoms, such as:
- The spots turn yellowish
- There is a lot of fluid coming out of the spots
- The skin around the patch is inflamed (swelling, heat, and pain)
- happy
When to go to the doctor
Consult a 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.
Follow medical check-up employees provided by the company on a regular basis, if work puts you at high risk of exposure to chemicals, such as formalin or mercury.
Numular Dermatitis Causes
The exact cause of nummular dermatitis is unknown. Even so, most cases of nummular dermatitis are considered to occur because the patient has very dry skin conditions (xerosis) and is sensitive to 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 glues, coatings, or fabrics.
- Medications, especially antibiotics that are applied to the skin, such as neomycin.
In addition to the conditions above, the following risk factors also make a person more susceptible to developing nummular dermatitis:
- Male and over 50 years old.
- Have sensitive skin that is easily irritated due to the use of cleaning products, cosmetics or clothing with a rough texture.
- Have or have a family member with a history of allergies, asthma, or atopic dermatitis.
- Have conditions that cause obstructed blood circulation, especially in the legs, such as varicose veins and diabetes.
- Have minor skin injuries, such as insect bites, burns, or scratches by sharp objects.
- Taking certain medications, such as isotretinoin, interferon, or statin cholesterol drugs.
- Lives in dry or cold climates.
In addition, stress and changes in air temperature due to exposure to the sun or cold winds can also trigger the appearance of nummular dermatitis.
Numular Dermatitis Diagnosis
The doctor will ask the patient's complaints and symptoms, as well as trace the history of the disease that the patient and his family have suffered. After that, the doctor performs a physical examination by observing the skin area that has nummular dermatitis.
In some cases, these tests are sufficient to make a 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 by other tests because the treatment is different.
A number of investigations that can be done to confirm the diagnosis of skin disorders that occur are:
- skin scraping
This examination is done by scraping the surface of the skin that has dermatitis, to see the presence of fungi. The goal is to differentiate this disease from ringworm.
- Patch allergy test (patch testing)
The trick is to attach some substance to the skin, for example nickel metal. Allergy testing is done if the patient is suspected of having allergies.
- Skin biopsy
A skin biopsy is performed by taking a small sample of skin tissue from the affected area, which is then examined under a microscope. The goal is to see skin abnormalities that occur.
Numular Dermatitis Treatment
Treatment of nummular dermatitis aims to relieve symptoms and keep symptoms under control. This can be done with the following treatment options:
Self care
Patients can perform treatment 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 knitted materials.
- Avoid 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.
- Do not shower or bathe for too long, especially when using warm water.
- Apply a skin moisturizer or emollient to dry skin areas.
- 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 (oles) are the most common medications to treat nummular dermatitis. This drug works to reduce inflammation and reduce irritation in the area of the patch. Corticosteroid drugs in the form of tablets or injections can also be given in more severe cases.
- Antihistamines
Taking an antihistamine (allergy itch medication), such as cetirizine, can relieve itching and discomfort in 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 have serious side effects, so their use needs to be monitored by a dermatologist.
Ultraviolet (UV) radiation therapy
Therapy with UV light can be done when discoid eczema is severe enough and treatment with drugs does not give maximum results. Therapy is performed several times a week, for 6-12 weeks, 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 patients, these patches of nummular dermatitis can disappear completely without leaving a mark on the skin. But in some people, these patches can cause scars in the form of changes in skin color.
Numular Dermatitis Complications
There are several complications that can arise from nummular dermatitis, including:
- Bacterial infection
- Permanent skin discoloration in the area of dermatitis
- Sleep disturbances and difficulty concentrating
- Permanent scars in the area of dermatitis
- Cellulitis
Numular Dermatitis Prevention
Prevention of nummular dermatitis can be done by avoiding the trigger. Ways that can be done are:
- Keeping the skin hydrated, for example by diligently applying moisturizer, especially after bathing.
- Use 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 when using warm water.
- Wear loose clothing with materials that absorb sweat, such as cotton.
- Always comply with work safety rules and standards, especially in chemical-rich work areas.
- Manage stress well, for example with meditation or yoga.
- Living a healthy lifestyle, namely by implementing a balanced nutritious diet and exercising regularly.