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DISCOID (Nummular) ECZEMA
This condition can affect adults of all ages. It is however, predominant in middle-age males. It is characterized by multiple, extremely itchy, coin-shaped (circular or ovular) lesions (1-5mm in diameter).
In the initial stages a few isolated lesions may appear on the limbs (often on the site of an old physical or chemical scar or damage). This is then followed by multiple “outbreaks” over various parts of the body. This may occur rapidly over as little as ten days after the first appearance of the spots or may take several months to evolve. The spots are usually formed as a result of the “cluster” effect of the densely distributed red, fluid filled blisters. These become weepy, crusted and very itchy.
As the scaling progresses there is often a “central healing” with the outer leading edge extending the coin-shaped lesions. With time they clear to a dull red, leaving dry scaly patches.
Often associated with asteatotic eczema, it appears mainly in adults over the age of 50 who have dry skin that is exacerbated by central heating and low humidity.
Unlike asteototic eczema, where the patients usually have a background working in an environment and where they have been constantly exposed to chemicals, discoid patients are usually from managerial, white collar professional or secretarial backgrounds.
With a secondary (staphylococci) infection, the lesions will become increasingly “wet, weepy and pustular ”. At this stage rapid, severe spreading of the lesions will occur over much of the limbs and trunk region.
The condition can present in young females as Discoid Hand Eczema.
“Dry Discoid Eczema” consists of multiple “dry” scaly round or oval discs, mainly on the arms or lower legs. Sometimes even on the palms and soles. Itching is minimal.
All forms of discoid eczema are chronic and usually persists for months or even years with multiple reoccurrences at the sites of previously healed lesions.
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