The incidence of contact allergy in nummular eczema varies from 30.1% to 77.9% of cases [14Fleming C, Parry E, Forsyth A, Kemmett D. Patch testing in discoid eczema. Anolik RB, Lindsay TJ. Trashlieva M, Allergic … For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort. / afp Llewelyn-Edwards A, Horn R. The pattern of skin disease in general practice. Tyler W, Dr. Pickett has extensive experience treating a diverse background of patients. Henoch-Schönlein purpura. Treatment involves pain management with nonsteroidal anti-inflammatory drugs or acetaminophen. ... Nummular eczema Eczema types: Nummular … 25. You may be more likely to develop atopic dermatitis if you have a family history of atopic dermatitis, allergies, or asthma. Dattwyler RJ, Schaffer A, ", "These journals provide researchers with a platform for rapid, open access scientific communication. 5. Or it may cause the skin to blister, ooze, crust or flake off. Wolfrey J. J Am Acad Dermatol. Older people are however more prone to developing this skin problem. Jindal N, [http://dx.doi.org/10.1097/DER.0b013e318260d5a0] [PMID: 228282 53] , 18Patrizi A, Ricci G, Neri I, et al. Stulberg DL, 1999;29(suppl 3):109–112. Nummular eczema. Wisco OJ, Between non-atopic and atopic nummular eczema there are several significant differences. Pityriasis rosea. Want to use this article elsewhere? [PMID: 5804349] -17Bonamonte D, Foti C, Vestita M, Ranieri LD, Angelini G. Nummular eczema and contact allergy: A retrospective study. Eczema in chiazze nell’infanzia: Studio retrospettivo di 515 casi. Erythema multiforme. 2007;76(11):1709–1710. The articles published in the open access journals are high quality and cover a wide range of fields. Online Manuscript Submission and Tracking System, https://creativecommons.org/licenses/by/4.0/legalcode, http://dx.doi.org/10.1002/9781444317633.ch23, http://dx.doi.org/10.1001/archderm.1953.01540070072010, http://dx.doi.org/10.1111/j.1365-2133.1975.tb06789.x, http://dx.doi.org/10.1111/j.1346-8138.2009.00677.x, http://dx.doi.org/10.1093/oxfordjournals.bmb.a072887, http://dx.doi.org/10.1001/jama.1968.03150030093022, http://dx.doi.org/10.1111/j.1365-2133.1974.tb13074.x, http://dx.doi.org/10.1001/archderm.141.1.102-b, http://dx.doi.org/10.1097/DER.0b013e318260d5a0, http://dx.doi.org/10.1001/archderm.1973.01620160028006, http://dx.doi.org/10.1111/j.1398-9995.2008.01731.x, http://dx.doi.org/10.1111/j.1600-0536.1997.tb00214.x, http://dx.doi.org/10.4103/0378-6323.18945, http://dx.doi.org/10.1097/DER.0000000000000046, http://dx.doi.org/10.1111/j.1346-8138.2002.tb00219.x, Nummular Contact Eczema: Presentation of a Pediatric Case.      Print. Smith G, Interventions for preventing and treating kidney disease in Henoch-Schönlein purpura (HSP). Asian Pac J Allergy Immunol 2013; 31(1): 36-42. Krueger GG, Kahn G, Weston WL, Mandel MJ. Leprosy, also called Hansen disease, is caused by the bacteria Mycobacterium leprae. von Vigier RO, Am Fam Physician. More often, it occurs during the fall-winter period. Since atopic dermatitis may also present with different clinical phenotypes, among which nummular eczema is quite frequent, the possible significant differences between non-atopic and atopic nummular diseases are … When nummular eczema is etiologically linked to infections, alcohol abuse or exogenous chemical agents, it resolves quickly without recurrence with specific treatments and prevention. A survey of 84 case records. Peters JI, Smith G, Fite-Faraco staining in combination with multiplex polymerase chain reaction: a new approach to leprosy diagnosis. Ulcerative sarcoidosis. Feder HM Jr, Werth V. Acta Derm Venereol 1960; 40: 114-26. 35. [http://dx.doi.org/10.1097/DER.0b013e318260d5a0] [PMID: 228282 53] ]. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. Randomised, double-blind, placebo-controlled trial to determine whether steroids reduce the incidence and severity of nephropathy in Henoch-Schonlein purpura (HSP). Dermatitis 2014; 25(4): 155-62. 34. 7. Dermatol Pract 1986; 4: 14-9.] Feily A, 42. Diagnosis and treatment of lichen planus. Precipitants in 42 cases of erythema multiforme. Dermatology. Trashlieva M, Urticaria. 33. et al. Atopic dermatitis, however, can occur with nummular lesions in both children and adults [18Patrizi A, Ricci G, Neri I, et al. The articles are high standard and cover a wide area. Reid-Adam J. Nummular eczema, also called discoid eczema or nummular dermatitis, is a chronic inflammatory skin disease characterized by multiple pruritic, coin-shaped eczematous lesions involving the extremities and, less commonly, the trunk (picture 1A). Lindsay TJ. Usatine RP, Price HN. Examples of this condition are atopic dermatitis (eczema), dandruff and contact dermatitis.Dermatitis isn't contagious, but it can make you feel uncomfortable and self-conscious. Many diseases present with cutaneous annular lesions, making distinction by physical appearance alone challenging. Stonehouse A, 1857; 238.] Fixed drug eruption (FDE): changing scenario of incriminating drugs. [http://dx.doi.org/10.1001/jama.1968.03150030093022] [PMID: 569 5586] , 9Aoyama H, Tanaka M, Hara M, Tabata N, Tagami H. Nummular eczema: An addition of senile xerosis and unique cutaneous reactivities to environmental aeroallergens. Arch Dermatol 1973; 107(1): 56-8. Tizard J. Sloan SB, Early prednisone therapy in Henoch-Schönlein purpura: a randomized, double-blind, placebo-controlled trial. Hsu S, It can also occur along with those types of eczema, though it often appears as an isolated condition. Granuloma annulare can be associated with type 1 diabetes, dyslipidemia, and some malignancies. People … Systemic lupus erythematosus: primary care approach to diagnosis and management. The diagnosis can be made clinically based on the presentation of skin lesions with arthritic symptoms and colicky abdominal pain. Described by Devergie [21Devergie MGA. The lesions of plaque psoriasis are pruritic, sharply demarcated, erythematous, and round or ovoid, with silver plaques that bleed easily with trauma 10 (Auspitz sign; Figure 3). Wen W, Swick BL. 36. It may also keep coming back – often in the same area that was affected previously. Assessment of urticaria and angiooedema. Rollins TG. Signs and symptoms of untreated Lyme disease. Nummular Eczema baby issues can be especially difficult and complex to treat and should be treated by a pediatric dermatologist that specializes in Nummular Eczema baby treatments. [http://dx.doi.org/10.1111/j.1346-8138.2009.00677.x] [PMID: 1969 1752] ] and emotional [6Baer TW. Pediatr Infect Dis J. Patch testing in nummular eczema: comparison of patch test results between nummular eczema and atopic dermatitis. Etiology of nummular eczema. The rash presents as violaceous ecchymoses, petechiae, and palpable purpura (Figure 11). Nummular eczema can look like psoriasis, ringworm, fungal infection and other types of eczema, including atopic dermatitis, stasis dermatitis and contact dermatitis. 2011;83(3):307. 6. McCleskey PE, J Dtsch Dermatol Ges 2011; 9(1): 12-20. Reamy BV, While its clinical aspects are clearly defined and known, its pathogenetic mechanism is not. Reprinted with permission from Hsu S, Le EH, Khoshevis MR. [http://dx.doi.org/10.1093/oxfordjournals.bmb.a072887] [PMID: 790 8595] ] and dry skin, especially in old age [8Rollins TG. Dermatol Clin. Nummular eczema. Nummular lesions, both in pediatric and adult age, are more exudative, unlike the usually dry and scaling atopic ones, and are less numerous, asymmetric and irregularly shaped and resolve with hyperchromic or hypochromic outcomes (especially in atopics) [31Kang IJ, Shin MK, Haw CR. Pugliarello S, Cozzi A, Gisondi P, Girolomoni G. Phenotypes of atopic dermatitis. Urticaria is a condition that develops in response to the release of histamines, resulting in increased vascular permeability and massive edema in the superficial dermis. Indeed, the research articles span a wide range of area and of high quality. Dermatitis is a general term that describes a skin irritation. Shengyuan L, Nummular eczema: Nummular eczema produces scaly, coin-shaped patches that are very itchy. Pityriasis rosea. Am Fam Physician. 21. 2012. http://www.searo.who.int/entity/global_leprosy_programme/publications/8th_expert_comm_2012.pdf. 1, 2). A pruritic, annular, erythematous patch that grows centrifugally should prompt evaluation for tinea corporis. Tinitigan M. 2011;25(1):24–26. Differential diagnosis of annular lesions, Reprinted with permission from Lam NC, Ghetu MV, Bieniek ML. Rosenbach M. Previous: Radon: A Leading Environmental Cause of Lung Cancer, Next: Common Foot Problems: Over-the-Counter Treatments and Home Care, Home The preferred treatment is parenteral penicillin G benzathine.41 Proper treatment is essential because disease progression results in severe cardiac and neurologic complications. It is therefore desirable that all cases of persistent nummular eczema, both in atopic and non-atopic subjects, should be patch tested [34Bonamonte D, Foti C, Carpentieri A, et al. Erythema migrans. Jindal N, Tan SH. Ng PP, Uses: Based on a review of this drug by the National Academy of Sciences-National Research Council and/or other information, FDA has classified the indications as follows: -Possibly effective: Contact or atopic dermatitis; impetiginized eczema; nummular eczema; infantile eczema; endogenous c… Author disclosure: No relevant financial affiliations. Indian J Dermatol Venereol Leprol. Griffiths CE. Cyr PR. 2006;74(11):1883–1888. Villiger RM, J Dermatol 2002; 29(12): 763-7. Talwani R, Among these, contact allergy is often the primary cause. This content is owned by the AAFP. Mohan M, 2016;94(4):289. Patients may have decreased sensation to pain, temperature, and touch over the lesions. Differential diagnosis of annular lesions. Tina Pickett, MD is a board certified dermatologist with over 25 years’ experience working in the metro Detroit area. McCleskey PE, 27. Scaly, pruritic lesions with poorly demarcated borders. ], nummular eczema is not a separate affliction, but a morphological entity in whose onset several factors contribute [17Bonamonte D, Foti C, Vestita M, Ranieri LD, Angelini G. Nummular eczema and contact allergy: A retrospective study. Srivastava G. Scaly, erythematous annular plaques with raised borders that spread centrifugally, Lesions develop after close contact with infected persons, animals, or soil; warm, moist environments exacerbate lesions, Potassium hydroxide preparation may detect segmented hyphae, Treatment options include topical and systemic antifungals, Expanding, erythematous, annular rash with or without central clearing, Lesion appears three to 30 days after tick bite, often preceded by an influenza-like prodrome of fever, malaise, and myalgias, Treatment options include doxycycline, amoxicillin, cefuroxime (Ceftin), and ceftriaxone (Rocephin), Well-demarcated, erythematous, annular plaques with adherent silvery scales, Pruritic lesions often associated with stress, alcohol, or friction, Treatment options include topical steroids and vitamin D analogues for mild cases; and systemic corticosteroids, phototherapy, and biologic agents for severe cases, Multiple raised, annular, target-like lesions with central erythema, Lesions develop over a few days and usually resolve within three to five weeks without treatment; 90% of cases are associated with herpes simplex virus type 1, and 10% of cases are associated with medications or vaccinations, Treatment options include antivirals and systemic corticosteroids for recurrent symptoms, Violaceous, flat-topped papules with fine white or gray reticular, lacy lines on top of the rash, Pruritic rash that bleeds with trauma; most commonly involves the ankles and volar surfaces of the wrist; lesions can be intraoral; associated with certain drugs and hepatitis C infection, Diagnosis is clinical, but biopsy can confirm, Treatment options include topical corticosteroids, systemic glucocorticoids, and ultraviolet A or B phototherapy, Coin-shaped, erythematous, scaly, annular lesions, Intensely pruritic; most commonly involves the extremities, Diagnosis is clinical; potassium hydroxide preparation can rule out tinea corporis, Treatment includes minimizing skin dryness and reducing exposure to skin irritants; topical corticosteroids for mild symptoms; and ultraviolet B phototherapy and systemic corticosteroids for severe symptoms, Salmon-colored, demarcated, annular or ovoid lesions with scaly borders slanted backward, Usually asymptomatic; more common in females; follows skin cleavage lines, Treatment options include topical corticosteroids, oral antihistamines, and ultraviolet A or B phototherapy; systemic corticosteroids may be used for severe symptoms, Intensely pruritic; may affect any area of the body; usually lasts 90 minutes to 24 hours, Empiric treatment options include antihistamines and corticosteroids, Tinea corporis is a dermatophyte infection that can occur on any cutaneous surface other than the hands, feet, scalp, or groin. Dermatitis 2012; 23(4): 153-7. Enlarge In: Buttaravoli P, Leffler SM. Henoch-Schonlein purpura. 9. Sites of predilection include the … Centers for Disease Control and Prevention. Hassink RI, Asian Pac J Allergy Immunol 2013; 31(1): 36-42. Clin Chest Med. Lesions consistent with pityriasis rosea that do not resolve spontaneously in three months should be considered for biopsy. It does not represent a precise etiological entity, and indeed various causative factors, acting individually or in a combined manner, have been identified and suggested as presumable etiological agents. Get Permissions, Access the latest issue of American Family Physician. 2010; Vol. Its relationship to internal foci of infection. Abeles M, Am Fam Physician. 46. Precipitants in 42 cases of erythema multiforme. Rayer P. Theoretical and Practical Treatise of Diseases of the skin 1845; 114. The dehydration dermatosis. 2007;45(7): 941]. Biswas N, Whitaker-Worth D, 2016;93(5):397–398. The rash commonly develops during cold, dry months and is often associated with atopic dermatitis and asthma. Friedmann PS. ", "Open access journals are probably one of the most important contributions to promote and diffuse science worldwide. Immunoglobulin A vasculitis. ", "Open access journals have become a fundamental tool for students, researchers, patients and the general public. Lesions often appear on the ankles and volar surfaces of the wrists, but they can also appear on oral mucosa. Systemic corticosteroids can minimize the severity of joint and abdominal pain.38 However, a 2015 Cochrane review did not support the use of corticosteroids for the prevention of nephritic disease.39 A recent randomized controlled trial found no significant difference in proteinuria at 12 months after the onset of IgA vasculitis in children who received prednisolone for 14 days compared with those who received placebo.40, The rash of secondary syphilis is diffuse, symmetric, erythematous, and annulopapular (Figure 12). Rosenbach M. Treatment options include topical or systemic corticosteroids, as well as UVA and UVB phototherapy.17. Chronic plaque psoriasis. Albertini JG, Nummular eczema causes J Dtsch Dermatol Ges 2011; 9(1): 12-20. Nummular Eczema is a chronic condition that affects people of all ages including infants and young children. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Skin lesions develop in sun-exposed areas of the body (Figure 14).46 Laboratory testing for autoimmune antibodies will often be positive for antinuclear and anti–Sjögren-A antibodies and negative for anti–double-stranded DNA antibodies. The ovoid appearance of this lesion is caused by variable rates of extension of the … To prevent nummular dermatitis from returning once your skin clears, dermatologists recommend the following care. ", "Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets. 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Are precipitated by three types of events: allergic, physical, or asthma to. May be papular, vesicular or exudative ( oozing ) erythematous or violaceous patches or that. Figure 4 ): 406-8 acyclovir is the reason why I support this endeavor freely new knowledge and to! Researchers, patients and the size of the lesion varies from 1 to 10 days of stopping causative... In severe cardiac and neurologic complications S, Trashlieva M, van Zuuren EJ, Fedorowicz,.