Coin-like (nummular) eczema: causes and treatment

Coin-like eczema is a skin disease characterized by
round, intensely itchy foci of inflammation. It is because of the shape
spots that resemble coins, the disease got another
name – nummular (from Latin numisma-coin) eczema. This
pathology is difficult to treat and difficult for patients to endure.
Most often, coin-like eczema occurs in the elderly.
men, but it also occurs in people of any age and gender with
very dry skin. Often the disease develops in patients with
atopic dermatitis on the background of chronic infection.


  • Causes of Coin Eczema
  • Symptoms of the disease
  • Diagnosis of the disease
  • Treatment of Coin Eczema
  • Disease prevention

Causes of Coin Eczema

The exact causes of the disease have not yet been identified, but
There are a number of factors that can trigger

  • hyperhidrosis (sweating);
  • endocrine disruption;
  • disruptions in the hormonal system;
  • pathology of the nervous system;
  • psycho-emotional disorders;
  • metabolic disease;
  • excision (loss of significant amounts of water by the body and


Scientists believe that coin-like eczema results from
reduce the protective functions of the epidermis that make it vulnerable to
negative impact of external factors.

Symptoms of the disease

Despite the fact that coin-like eczema has its own characteristic
differences, it is often mistaken for a harmless fungal dermatosis.
However, the symptoms of coin-like eczema, unlike dermatosis,
have greater resistance to therapy.

Coin eczema is characterized by round formations.
eczematous inflammation. The spots have a clear rounded shape and
strictly delineated. They rise above the skin and have
size from 1 to 5 cm. Stains are usually saturated red,
burgundy or bluish color. In the acute stage of eczema
causes intolerable itching, soak and flakes. Push to
secondary infection can become a development of coin-like eczema,
which appears due to the entry of pathogenic microbes into open
wounds. Eczema localized on the inside of the thighs, then the lesions
lesions spread to the arms, legs, and torso.

In the acute phase of development, coin-like eczema is characterized
round plaques that are covered with brown crusts. AT
further plaques are covered with cracks, pus and
ichor. This fact suggests that the infection has affected deep
skin layers and small capillaries. Chronic form of coin-like eczema
manifested by the growth of plaques, their merger into one extensive
generalized type conglomerate. Against the background of the acute form
the disease is observed deterioration of the patient’s general condition:
weakness, fever, headaches. In remission
skin cracks appear, it becomes very dry and rough.

Diagnosis of the disease

The doctor – dermatologist diagnoses the disease, based on
clinical picture and symptoms. To confirm the exact
diagnosis conduct additional microbiological research.
Bacteriological seeding can confirm the presence in the body
Staphylococcus aureus (Staphylococcus aureus). Required
conduct differential diagnostics of coin-like eczema
following diseases:

  • scabies;
  • psoriasis;
  • cutaneous T-cell lymphoma;
  • fungal dermatosis.

In psoriasis, the rashes are covered with silvery scales, have
symmetrical localization and characteristic “geographical”

Fungal dermatosis is differentiated with potassium hydroxide. AT
case of fungal dermatosis formed spots
flakes off only around the edges, leaving the center “clean.”

Lesions for psoriasis and fungal infections are clearer,
borders of rashes sharply delineated. Typical lesions:
trunk, legs, hands, upper limbs.


Cutaneous T-cell lymphoma is differentiated by
biopsy. It is localized exclusively on the lower extremities.

Treatment of Coin Eczema

Treatment of nummular eczema is extremely difficult and
long lasting. Therapy contains a whole range of activities that
include the following actions:

  • local care for affected skin;
  • medication, namely
  • fortifying drugs (use of immunomodulators);
  • preventive actions.

In the acute stage of the disease in the presence of moist eczema prescribed
wet-drying dressings with drugs. Also at
local therapy impose compresses and lotions based on
various pharmacological drugs that have
anti-inflammatory, disinfecting, drying and astringent

In severe cases, prescribe antibiotics, antifungal
drugs and corticosteroids in the form of injections and tablets. Good
the effect is given by PUVA-therapy, the essence of which lies in the irradiation of the skin
longwave ultraviolet radiation. Once gone
acute stage and ulcers dried, prescribe tar paste and zinc
ointments, creams with antibiotics, heliomycin ointment, lincomycin
paste, antibiotic based sprays and

Disease prevention

Coin eczema is a very disease-resistant disease. She is
has an unpredictable and changeable course. Disease for many years
alternating remissions and relapses. The resulting lesions have
propensity for constancy: the affected areas retain their size
and periodically recur. Disease prevention lies in
observance of special rules of skin care. Needed daily
take a shower or bath to soak dry plaques, and
then treat them with moisturizing and emollients:
creams, balms, oils.

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