eMedicine Specialties > Dermatology > Reactive & Inflammatory Dermatoses

Nummular Dermatitis: Follow-up

Author: Jami L Miller, MD, Assistant Professor, Division of Dermatology, Department of Internal Medicine, Vanderbilt University Medical School; Director of Phototherapy Unit, Vanderbilt University Medical Center; Consulting Attending Physician, Nashville Veterans Affairs Medical Center
Contributor Information and Disclosures

Updated: Aug 3, 2009

Follow-up

Deterrence/Prevention

  • Aggressive hydration of the skin may decrease the frequency between nummular dermatitis eruptions.
  • Bathing is permissible, but hot water should be avoided.
    • Patients should use mild, nondrying cleansers. Patients should be encouraged to use nonsoap cleansers only for control of body odor and cleanliness (eg, on the groin, axillae, and feet). Oil additives may be used in bathing water.
    • To avoid drying of the lesions, an emollient should be used immediately after bathing. The skin may be patted dry, and the emollient should be applied before the skin is completely dry.
    • Clothing should be loose to avoid overheating, and irritating fibers, such as wool, should be avoided.
  • A room humidifier is useful, particularly when a heater or air conditioning is used.

Complications

  • Nummular dermatitis Lesions may become secondarily infected.
  • Heavily excoriated or infected lesions may leave permanent scars.
  • Lesions on the lower extremities take a long time to heal and may leave permanent brown macules.

Prognosis

  • Patients need to be informed that once nummular dermatitis develops, it is often recurrent. Avoidance of exacerbating factors and close attention to moisturizing the skin may help reduce the frequency.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Few medicolegal pitfalls apply to nummular dermatitis. Aggressive hydration, early treatment of secondary infection, and counseling regarding somnolence (due to medications or lack of sleep due to itching) are important to minimize the eruption and scarring and help avoid danger to the patient.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Khristina Collins, MD, and Lloyd King, MD, and previous Chief Editor, William D. James, MD, to the development and writing of this article.



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References
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Further Reading

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Keywords

nummular dermatitis, discoid eczema, nummular eczema, nummular eczema, coin-shaped eczema, coin-shaped dermatitis, nummular pruritus, Staphylococcus aureus, S aureus, staphylococcal skin infection, staphylococcal dermatitis

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Contributor Information and Disclosures

Author

Jami L Miller, MD, Assistant Professor, Division of Dermatology, Department of Internal Medicine, Vanderbilt University Medical School; Director of Phototherapy Unit, Vanderbilt University Medical Center; Consulting Attending Physician, Nashville Veterans Affairs Medical Center
Jami L Miller, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

John D Wilkinson, MD, MBBS, MRCS, FRCP, Chairman, Clinical Director, Department of Dermatology, Amersham Hospital and High Wycombe Hospital, UK
John D Wilkinson, MD, MBBS, MRCS, FRCP is a member of the following medical societies: American Academy of Dermatology and Royal College of Physicians
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Paul Krusinski, MD, Director of Dermatology, Professor, Department of Internal Medicine, Fletcher Allen Health Care, University of Vermont
Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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