Nummular eczema

Question 1

Other term for nummular eczema?

Answer 1

• Nummular dermatitis

- Discoid eczema

Question 2

What is the cause of nummular eczema?

Answer 2

Unknown etiology

Chronic inflammatory skin disorder

Question 3

describe nummular eczema

Answer 3

papules and papulovesicles coalesce to form nummular plaques with oozing, crust and scale

Question 4

common sites of involvement of nummular eczema?

Answer 4

• upper extremities in men and women, particularly the dorsal hands in women
• lower extremities in men

Question 5

nummular dermatitis, lsc and prurigo nodularis

each of these disorders may present in patients with?

Answer 5

atopic and contact dermatitis

however, these disorders often present in the absence of atopic disease and may be associated with underlying systemic disease

Question 6

nummular lesions are commonly observed in?

Answer 6

atopic dermatitis

Question 7

nummular lesions have a predilection for what age group?

Answer 7

school age children with AD

adult onset AD

Question 8

A large proportion of patients with nummular eczema have underlying what?

Answer 8

allergic contact dermatitis

Question 9

What is the age group where nummular eczema is common?

Answer 9

it is more common in adults
multiple observed peak ages-of-onset at 15-25 and
65-74 years old
Previous studies found conflicting results about whether nummular eczema is more common in adult males or adult females
No racial or ethnic predilection for nummular eczema has been demonstrated

Question 10

What is the pathogenesis of nummular eczema?

Answer 10

Many of the proposed triggers of nummular eczema overlap with those of AD, including

1. atopy
2. xerosis
3. exogeneous insult by irritants and/or allergens, microbiome
4. infection

Nummular eczema does not appear to be consistently associated with atopy
Most studies found low or normal rates of personal and or family history of atopy

Question 11

nummular eczema in elderly patients is associated with what clinically?

Answer 11

xerosis and lower hydration of the stratum corneum

*However, in contrast with AD, the water-barrier function of stratum corneum in nummular eczema appears to be normal.

Question 12

Moreover, epidermal and dermal inflammation occuring in nummular eczema was found to be predominated by?

Answer 12

T cells. With even higher T cell counts compared to AD.

Question 13

What are the triggers of nummular eczema?

Answer 13

Nummular eczema has been reported to be trigerred by exposure to irritants and environmental factors

• nummular eczema most commonly flares in the wintertime
• A role for environmental allergens, such as the house dust mite and Candida Albicans has also been touted.

Question 14

A large subset of nummular eczema may be related to what?

Answer 14

Allergic contact dermatitis
Retrospective studies of patch testing results for patients with nummular eczema found that 32.5% to 50% had at least one positive allergen, of which 12% to 67% were felt to be clinically relevant
Patients may develop nummular eczema-like reactions to their topical medicaments
Generalized nummular eczema may be caused by oral and/or topical exposures to allergens

Question 15

Microbial colonization and/or infection may play a role in what?

Answer 15

Nummular eczema

Question 16

What is a common and clinically relevant trigger of nummular eczema?

Answer 16

Emotional stress

Question 17

Nummular eczema has been reported during therapy with what medications?

Answer 17

1. isotretinoin
2. gold
3. combination therapy with interferon alpha-2b
4. ribavirin for hepatitis C
5. infliximab
   Mercury amalgam was implicated as a cause of nummular eczema in 2 patients