Nummular eczema
Nummular eczema appears as a delayed inflammatory reaction of a skin hypersensitive to antigens of microbes and only if the barrier function of the skin is damaged. It is probably a reaction on other infection in the body, such as yeast and streptococcal infection.
There are oval, reddened areas appearing on the skin with sharp edges, commonly of a size of 1–5 cm or more. The areas are composed of small pimples and blisters. Blisters crack and transform to oozing surfaces, or, on contrary, the deposit is extremely dry and peels off. Healing is scar free, change in pigmentation can occur.
The nummular eczema treatment depends on the character of the deposits. It always has to include an antimicrobial and anti-inflammatory component. Slightly oozing form requires baths only, suitable are highly diluted potassium permanganate (with light pink color), 3% solution of boric acid, or Solutio Jarisch. The skin has to be kept smooth and sterile after the bath. Apply for example a zinc oil, ichtoxyl black ointment or cosmetically unattractive but effective gentian violet. Eczema should be further cured with prescription ointment containing corticosteroids.
You can try to lubricate dry and peeling deposits with non-prescription ointments with anti-inflammatory, moisturizing and anti-itch component, such as Imazol or Halicar. More effective are prescription ointments containing corticosteroids.
The manifestation of irritated skin can be often confused with other diseases. If the above-described treatment turns out to be ineffective or the symptoms appear again in several weeks, the change in diagnosis towards a fungal disease should be considered, e.g., tinea corporis transmissible from animals.
Prevention: Due to the fact that this disease often relapses, it is necessary to observe some measures. Washing the skin too often and with common soaps and shower gels that change the pH of the skin is not appropriate. The pH-neutral products are more suitable in this case. The skin should avoid contact with irritating or allergenic substances by wearing gloves and protective products. For these purposes, the modern barrier creams seem to be an ideal choice. The microbes do not thrive on flexible, well moisturized and undamaged skin.
