Nummular dermatitis

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Nummular dermatitis
Other names: Discoid dermatitis, Discoid eczema, Microbial eczema, Nummular eczema, Nummular neurodermatitis
Lesions visible on outer thigh
Differential diagnosisDermatophytosis (Ringworm)

Nummular dermatitis is one of the many forms of dermatitis.[1] it is characterized by round or oval-shaped itchy lesions.[2] The name comes from the Latin word "nummus," which means "coin."

Signs and symptoms

Nummular dermatitis is characterized by chronic or relapsing itchy coin-sized ovoid-shaped red plaques.[3][4] They can occur on the trunk, limbs, face, and hands.[1][2][5]


Many contact sensitizers or irritants are known to cause contact dermatitis superimposed on nummular dermatitis. Studies have implicated nickel, cobalt, chromate, and fragrance as likely culprits.[6][7] Xerosis, or dehydration of skin is also a likely cause.[8] Infection with Staphylococcus aureus bacteria or Candida albicans may also play a role.[8]


Diagnosis of nummular dermatitis is largely via clinical observation. Biopsies are typically not necessary, and cannot be used to rule out other atopic dermatitis or other eczemas.[9][10] However, patch testing may be employed to rule out irritants (contact dermatitis) as a cause.[6][11] In children, nummular dermatitis is commonly confused with tinea corporis.[8]


One of the keys to treatment and prevention involves keeping the skin moisturized. Lotions, creams, and bath oils may help prevent an outbreak. If the condition flares up, a common treatment involves the application of topical corticosteroids. Oral antihistamines may help lessen itching. Avoidance of irritants is a common strategy. More severe cases sometimes respond to ultraviolet light treatment. If the condition occurs only during the sun-less winter months then vitamin D supplement might be an effective treatment.[citation needed]


The prevalence of nummular dermatitis in the United States is approximately 2 per 1,000.[12] It is considered a disease of adulthood, for it is rare in children.[13]

See also


  1. 1.0 1.1 Cowan, M. A. (1961-01-01). "Nummular eczema. A review, follow-up and analysis of a series of 325 cases". Acta Dermato-Venereologica. 41: 453–460. ISSN 0001-5555. PMID 13881857.
  2. 2.0 2.1 WEIDMAN, ABRAHAM I. (1956-01-01). "Nummular Eczema". AMA Archives of Dermatology. 73 (1): 58–65. doi:10.1001/archderm.1956.01550010060006. ISSN 0096-5359. PMID 13275125. Archived from the original on 2017-04-02. Retrieved 2017-04-01.
  3. ADACHIA, A (2000). "Mercury-induced nummular dermatitis". Journal of the American Academy of Dermatology. 43 (2): 383–385. doi:10.1067/mjd.2000.102457.
  4. Rollins, Troy G. (1968-10-14). "From Xerosis to Nummular Dermatitis: The Dehydration Dermatosis". JAMA. 206 (3): 637. doi:10.1001/jama.1968.03150030093022. ISSN 0098-7484. PMID 5695586.
  5. Perry, Adam D.; Trafeli, John P. (2009-05-01). "Hand Dermatitis: Review of Etiology, Diagnosis, and Treatment". The Journal of the American Board of Family Medicine. 22 (3): 325–330. doi:10.3122/jabfm.2009.03.080118. ISSN 1557-2625. PMID 19429739.
  6. 6.0 6.1 Khurana, Sandeep; Jain, V. K.; Aggarwal, Kamal; Gupta, Sanjeev (2002-12-01). "Patch testing in discoid eczema". The Journal of Dermatology. 29 (12): 763–767. doi:10.1111/j.1346-8138.2002.tb00219.x. ISSN 0385-2407. PMID 12532040.
  7. Bonamonte, Domenico; Foti, Caterina; Vestita, Michelangelo; Ranieri, Luigi Davide; Angelini, Gianni (2012). "Nummular Eczema and Contact Allergy". Dermatitis. 23 (4): 153–157. doi:10.1097/der.0b013e318260d5a0. PMID 22828253. Archived from the original on 2019-12-11. Retrieved 2017-04-01.
  8. 8.0 8.1 8.2 Williams, Hywel C. (2005-06-02). "Atopic Dermatitis". New England Journal of Medicine. 352 (22): 2314–2324. doi:10.1056/NEJMcp042803. ISSN 0028-4793. PMID 15930422.
  9. Kulthanan, Kanokvalai; Samutrapong, Pailin; Jiamton, Sukhum; Tuchinda, Papapit (2007-12-01). "Adult-onset atopic dermatitis: a cross-sectional study of natural history and clinical manifestation". Asian Pacific Journal of Allergy and Immunology. 25 (4): 207–214. ISSN 0125-877X. PMID 18402293.
  10. Julián-Gónzalez, Rolando Elias; Orozco-Covarrubias, Luz; Durán-McKinster, Carola; Palacios-Lopez, Carolina; Ruiz-Maldonado, Ramon; Sáez-de-Ocariz, Marimar (2012-09-01). "Less common clinical manifestations of atopic dermatitis: prevalence by age". Pediatric Dermatology. 29 (5): 580–583. doi:10.1111/j.1525-1470.2012.01739.x. ISSN 1525-1470. PMID 22469300.
  11. Krupa Shankar, D. S.; Shrestha, Shristi (2005-11-01). "Relevance of patch testing in patients with nummular dermatitis" (PDF). Indian Journal of Dermatology, Venereology and Leprology. 71 (6): 406–408. doi:10.4103/0378-6323.18945. ISSN 0378-6323. PMID 16394482. Archived (PDF) from the original on 2020-09-30. Retrieved 2019-09-05.
  12. T., Johnson, Marie Louise (1977-01-01). "Prevalence of dermatological disease among persons 1-74 years of age: United States". ADV Data Natl CTR Health Statistics. Archived from the original on 2017-04-02. Retrieved 2017-04-01.
  13. Krol, Alfons; Krafchik, Bernice (2006-03-01). "The differential diagnosis of atopic dermatitis in childhood". Dermatologic Therapy. 19 (2): 73–82. doi:10.1111/j.1529-8019.2006.00058.x. ISSN 1529-8019. PMID 16669989.

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