NUMMULAR ECZEMA ( DISCOID ECZEMA)

• The word nummular means (latin – nummulus) coin like. It is a chronic inflammatory skin condition characterized by well demarcated round lesions.

• Multifactorial
• Primarily an immunological hypersensitivity reaction (dermatitis) due to xerosis and damage to the epidermal lipid barrier
• Additional risk factors: Other dermatological conditions, Bacterial infections, and medications such as interferon
• Risk factors include excessive bathing or other prolonged water exposure

• The eruption is characterized by pruritic, coin shaped, eczematous lesions , 2-5 cm large
• Well demarcated erythematous plaques
• The lesion tends to develop on the extensor surfaces of the extremities and trunk
• Nummular Eczema has a chronic course with frequent relapses
• The lesions usually occur in crops

Differential diagnosis

• Tinea corporis : scaling of the edge is more conspicuous
• Exogenous dermatitis & Irritant dermatitis : Occasionally presents with discoid response
• Psoriasis: Lesions are dry, scaling is more prominent and the irritation is milder

• Usually based on patient history and clinical appearance

• Prolonged water exposure should be avoided

Internal medicines

• Padolakaturohinyadi kashaya- reduce oozing
• Kulakadi kashaya
• Chandraprabha gulika
• Guggulu panchapala choorna with Madhu
• Kaisoraguggulu gutika
• Doosheevishari gutika 

Procedures

• Triphala /Guduchyadi kashaya kshalana
• Rasottamadi lepa
• Tiktaka ghrita – ext application
• Dineseladi / Neeli tailam / Sudhadoorvadi keram- ext application