Nummular Eczema

Diagnosis: Nummular Eczema

Nummular Eczema

Clinical Presentation

Nummular Eczema

Clinical History

Chronic relapsing pruritic dermatitis. Assess for triggers, atopic history, occupational exposures.

Treatment

Emollients as maintenance. Topical corticosteroids for flares. Calcineurin inhibitors for sensitive areas. Dupilumab or JAK inhibitors for moderate-severe disease.

Differential Diagnosis

• Psoriasis • Contact dermatitis • Scabies • Tinea corporis • Seborrheic dermatitis • Mycosis fungoides • Drug eruption

Key Learnings

• "Eczema" is a clinical pattern, not a single diagnosis — encompasses multiple subtypes • Impaired skin barrier function is central to pathogenesis • Spongiosis (intercellular edema in epidermis) is the histological hallmark • Acute: vesicles, weeping. Subacute: erythema, scale. Chronic: lichenification, fissuring • Superinfection with S. aureus is common and may cause flares

Tags: kodachrome, Nummular Eczema