What Is Discoid Eczema: Symptoms, Causes, and Diagnosis

Nummular dermatitis (ND) or nummular eczema, discoid eczema is an inflammation of the skin as a result of factors from outside and or in the body that cause skin disorders such as redness, swelling, aggravating lumps, tend to recur and last a long time.

What does discoid eczema look like?

The image of ND is initially in the form of a small wound with a size of 0.3-1.0 cm in the form of small fine spots that then merge so that a roundabout is formed like a coin, firmly bordered, slightly swollen and reddened.. Gradually the lump breaks, the yellow liquid comes out, then the wound can get bigger.

The size of the wound can reach a centerline of 5 cm or more. The number of skin disorders is only one, can also be many and spread, found on both sides of the right and left body. The size varies from 0.3–5 cm, or even more. The location of the wound is usually found in the lower limbs, body, back of the hands, and forearms.

Discoid eczema causes

Like other types of dermatitis, the cause of nummular dermatitis is not yet known with certainty. However, the researchers suspect that its appearance may be related to sensitive skin.

Nummular dermatitis itself is divided into two types, namely exudative nummular dermatitis and dry discoid eczema. Both are distinguished based on factors that may be the cause.

Here’s the difference between the two.

Exudative nummular dermatitis

Symptoms of exudative nummular dermatitis appear quickly and can last for months. Everyone can experience it, especially those aged 50 and over. In children, this condition is often mistaken for atopic dermatitis (eczema).

The first spots usually appear on areas of skin that have been injured or infection, for example as a result of:

• Burns
• Insect bites,
• Varicose vein surgery
• Scurvy, and
• Impetigo (infectious skin disease due to bacterial infection).

The disease is sometimes also caused by drug allergies, especially for the type of interferon alpha or injectable immunoglobulin. There are also cases of discoid eczema caused by contact dermatitis due to exposure to gold, nickel, or mercury metals.

Dry discoid eczema

Dry discoid eczema can appear on only one area of the skin or several parts of the body at once. This condition generally starts from dry skin due to eczema, excessive hand washing habits, or side effects of retinoid medications.

Discoid Eczema Diagnosis

The doctor will ask the complaints and symptoms experienced by the patient, and trace the history of the disease that has been suffered by the patient and his family. After that, the doctor performs a physical examination by observing the area of skin that has nummular dermatitis.

In some cases, the examination is enough to determine the diagnosis and treatment. However, often the symptoms of nummular dermatitis are similar to those of other skin diseases, such as ringworm, proriasis, or contact dermatitis, so it needs to be ascertained with other examinations because the treatment is different.

A number of supporting examinations that can be done to ensure the diagnosis of skin disorders that occur are:

Skin scraping

This examination is done by scraping the surface of the skin that has dermatitis, to see the presence of fungus. The goal is to distinguish this disease from ringworm.

Patch testing

The trick is to stick some substances on the skin, such as nickel metal. Allergy tests are done when the patient is suspected of having allergies.

Skin biopsy

Examination of skin biopsy is done by taking a small sample of skin tissue from the area that has abnormalities, to then be examined with a microscope. The goal is to see which skin disorders occur.