Nummular Eczema / Discoid Dermatitis
Nummular eczema (also called discoid dermatitis) is a chronic form of dermatitis marked by sharply defined round or oval patches and papules that look like coins. Unlike typical atopic dermatitis, it often flares after a minor skin injury, such as an insect bite or a scratch, or as a result of very dry skin. It can be intensely itchy and affects appearance, and without proper treatment the patches can become infected and leave stubborn dark marks.
At Haute-Derma, we treat more than the visible patches. We focus on strengthening the skin barrier and calming its immune response, so you can break the cycle of recurring flares.
How We Diagnose Nummular Eczema
Because nummular eczema is easily confused with fungal infection (ringworm) or psoriasis, we take a careful, step-by-step approach to diagnosis at Haute-Derma:
- KOH test for fungus: an essential step to rule out tinea corporis, which looks very similar but needs completely different treatment.
- Dermoscopy: examining the blood vessel and scale patterns to tell it apart from psoriasis or contact dermatitis.
- Bacterial culture: if the patches are oozing or have yellow crusts, we take a culture to check for secondary bacterial infection.
- Patch testing: when the eczema keeps returning in the same spots, your doctor may patch test to look for an allergic trigger such as nickel or other chemicals.
Modern Treatment Options at Haute-Derma
We build a plan that both clears active patches and protects the skin to keep them away:
- Potent topical corticosteroids: prescription-strength creams and ointments that quickly calm inflammation from the acute stage onward.
- Topical calcineurin inhibitors (TCIs): a safe choice for sensitive areas or for long-term maintenance, avoiding the side effects of steroids.
- Wet wrap therapy: a specialized technique that helps medication penetrate better and quickly soothes intense itching.
- Phototherapy: narrowband UVB for widespread disease or patches that do not respond to topical treatment.
- Topical or oral antibiotics: added when there are signs of secondary infection.
