Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
Discoid eczema causes eczema patches that are a raised, disc-shaped rash with well-defined borders. The patches are itchy and flaky and may weep and crust over. It most often develops on the lower legs, but can also appear on the arms, trunk, hands, or feet.
Discoid eczema is achronic condition. The patches can last for months, or years in some cases, and are likely to reoccur. Discoid eczema is also callednummular eczema, nummular dermatitis, and discoid dermatitis.
This article discusses the symptoms and causes of discoid eczema, as well as the diagnosis and treatment of this condition.
Verywell / Julie Bang
Discoid Eczema Symptoms
Discoid eczema causes very distinct circular, raised patches of irritated skin. The patches have well-defined borders and can range in size from a 1/4 inch to up to 4 inches in diameter.Some people develop just one or a handful of patches; others may get dozens.
The rash may heal completely between breakouts, but it doesn’t always. It’s quite common to have a breakout that lasts for many months.
Discoid eczema is a chronic condition. Once you’ve developed it, it’s likely to continue to come and go over the course of your lifetime.
Causes of Eczema Patches
No one knows exactly what causes discoid eczema to develop. What is certain is these eczema patches are more common in people who have a family history ofatopic dermatitis (AKA common eczema), allergies, and asthma or have one or more of these disorders themselves.
Certain environmental factors may trigger a breakout, including:
Discoid eczema often first appears after an injury, even a relatively small one like a burn, scrape, or insect bite.The rash can erupt anywhere on the body, but typically you’ll find it on the lower legs, the arms, and the trunk. It doesn’t often occur on the face.
Triggers
Men are slightly more likely than women to develop discoid eczema. In men, discoid eczema most often makes its first appearance after age 50. Women, on the other hand, are more likely to see it develop in late adolescence and early adulthood. That said, it can happen across all ages, though it is fairly uncommon in children.
Discoid eczema isn’t contagious, so you didn’t catch it from someone else. Likewise, you needn’t worry about passing the condition to another person.
Reproduced with permission from ©DermNet NZwww.dermnetnz.org2022
During a skin biopsy, a small bit of skin is removed so it can be studied under a microscope. Thedermatopathologist(a pathologist specializing in dermatology) will look for fungi or bacteria that may be causing your rash. Your healthcare provider may also decide to dopatch testingto test for allergies.
Discoid eczema can sometimes be mistaken for:
It’s important to get a proper diagnosis because, although they have similar symptoms, each of these skin problems is treated differently.
Treating Eczema Patches
Because eczema patches can be difficult to control once they appear, you’ll most likely need a prescription medication. To see the best results, you need to follow your healthcare provider’s instructions exactly for whichever treatment is prescribed.
It may take a few tries to find the treatment that works best for you. Keep your healthcare provider in the loop with how your treatment plan is going, especially if you aren’t seeing good results.
Medications
Medication options for discoid eczema include topical steroids, antibiotics, topical calcineurin inhibitors, antihistamines, and moisturizers.
Topical steroidsare the most common treatment for discoid eczema.Topical steroids help reduce inflammation and irritation. You’ll apply these creams once daily or up to several times daily, depending on the type of steroid and strength prescribed.
Topical steroids can cause thinning of the skin, hyperpigmentation (dark spots), and hypopigmentation (light spots), especially with long-term use. It’s important to use topical steroids exactly as directed. Daily use is not advised.
Topical calcineurin inhibitors (TCIs)are a group of medications that include Elidel (pimecrolimus) and Protopic (tacrolimus). These medications are approved for use in atopic dermatitis but are also sometimes prescribed for discoid eczema.
Oral antibioticsmay be prescribed if your eczema patches are infected, or if your discoid eczema is very severe.
Antihistaminesare not typically effective in treating severe itch seen in different forms of eczema including discoid eczema. If, however, itchiness is interfering with sleep, sedating antihistamines can be useful.
Moisturizersshould be used frequently. This is key to treating and preventing a recurrence.Apply an emollient cream immediately after bathing or showering, while the skin is still slightly damp.
Topical phosphodiesterase (PDE-4) inhibitorsinclude Eucrisa (crisaborole) and Zoryve (roflumilast). They have been FDA-approved for use in atopic dermatitis but may be prescribed for discoid eczema.
Avoid Triggers
Whenever possible, try to avoid environmental factors that can trigger a flare-up of discoid eczema (though in many cases you may not know the trigger). Certain things are more likely to trigger an outbreak including:
Ask for an allergy patch test if you think your eczema may be related to something you’re coming into contact with.
Eczema patches can be incredibly distressing to those who have it. You may feel like people are staring at your rash, or judging you for the condition of your skin.
Although it’s common for people dealing with discoid eczema (and other visible skin conditions like psoriasis and acne) to feel embarrassed about their skin, remember that discoid eczema is much more obvious to you than it is to anyone else.
Part of what makes discoid eczema so stressful is the feeling of being out of control of your skin. You don’t know when a breakout will occur and when it will go away.
Dealing With Itching
The itching of discoid eczema can be unbearable at times. Some people find the itching is worse just as the rash develops, while others say the itch continues until the rash heals. Either way, there are steps you can take to reduce the itch:
Itching often seems worse at night and can make it difficult to sleep. If this is the case, try timing the application of your topical steroid medications for just before bed, as they can help reduce the itch. You may also talk to your healthcare provider about taking an antihistamine.
Summary
Discoid eczema causes disc-shaped eczema patches that can be inflamed, itchy, scaly, and crusty. The exact cause isn’t known, but discoid eczema is more common in people who have a family history of atopic dermatitis, allergies, and asthma or have one or more of these conditions themselves.
Over-the-counter products are rarely helpful for this type of eczema, but avoiding triggers and taking medications such as topical steroids, antibiotics, topical calcineurin inhibitors, antihistamines, and moisturizers can be effective. Talk with your healthcare provider if you think you may have discoid eczema.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology.Nummular dermatitis: Signs and symptoms.Jiamton S, Tangjaturonrusamee C, Kulthanan K.Clinical features and aggravating factors in nummular eczema in Thais. Asian Pac J Allergy Immunol. 2013 Mar;31(1):36-42.U.S. National Library of Medicine.Nummular eczema. Medline Plus.American Academy of Dermatology.Nummular dermatitis: Causes.National Eczema Association.Nummular eczema - nummular dermatitis - discoid eczema.American Academy of Dermatology.Nummular dermatitis: Diagnosis and treatment.Purnamawati S, Indrastuti N, Danarti R, Saefudin T.The role of moisturizers in addressing various kinds of dermatitis: A review.Clin Med Res.2017;15(3-4):75-87. doi:10.3121/cmr.2017.1363American Academy of Dermatology.Nummular dermatitis: Tips for managing.Schut C, Mollanazar NK, Kupfer J, Gieler U, Yosipovitch G.Psychological interventions in the treatment of chronic itch.Acta Derm Venereol.2016 Feb;96(2):157-61. doi:10.2340/00015555-2177Additional ReadingSuh KS, Park JB, Yang MH, Choi SY, Hwangbo H, Jang MS.Diagnostic usefulness of dermoscopy in differentiating lichen aureus from nummular eczema.J Dermatol.2017;44(5):533-537. doi:10.1111/1346-8138.13701.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology.Nummular dermatitis: Signs and symptoms.Jiamton S, Tangjaturonrusamee C, Kulthanan K.Clinical features and aggravating factors in nummular eczema in Thais. Asian Pac J Allergy Immunol. 2013 Mar;31(1):36-42.U.S. National Library of Medicine.Nummular eczema. Medline Plus.American Academy of Dermatology.Nummular dermatitis: Causes.National Eczema Association.Nummular eczema - nummular dermatitis - discoid eczema.American Academy of Dermatology.Nummular dermatitis: Diagnosis and treatment.Purnamawati S, Indrastuti N, Danarti R, Saefudin T.The role of moisturizers in addressing various kinds of dermatitis: A review.Clin Med Res.2017;15(3-4):75-87. doi:10.3121/cmr.2017.1363American Academy of Dermatology.Nummular dermatitis: Tips for managing.Schut C, Mollanazar NK, Kupfer J, Gieler U, Yosipovitch G.Psychological interventions in the treatment of chronic itch.Acta Derm Venereol.2016 Feb;96(2):157-61. doi:10.2340/00015555-2177Additional ReadingSuh KS, Park JB, Yang MH, Choi SY, Hwangbo H, Jang MS.Diagnostic usefulness of dermoscopy in differentiating lichen aureus from nummular eczema.J Dermatol.2017;44(5):533-537. doi:10.1111/1346-8138.13701.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology.Nummular dermatitis: Signs and symptoms.Jiamton S, Tangjaturonrusamee C, Kulthanan K.Clinical features and aggravating factors in nummular eczema in Thais. Asian Pac J Allergy Immunol. 2013 Mar;31(1):36-42.U.S. National Library of Medicine.Nummular eczema. Medline Plus.American Academy of Dermatology.Nummular dermatitis: Causes.National Eczema Association.Nummular eczema - nummular dermatitis - discoid eczema.American Academy of Dermatology.Nummular dermatitis: Diagnosis and treatment.Purnamawati S, Indrastuti N, Danarti R, Saefudin T.The role of moisturizers in addressing various kinds of dermatitis: A review.Clin Med Res.2017;15(3-4):75-87. doi:10.3121/cmr.2017.1363American Academy of Dermatology.Nummular dermatitis: Tips for managing.Schut C, Mollanazar NK, Kupfer J, Gieler U, Yosipovitch G.Psychological interventions in the treatment of chronic itch.Acta Derm Venereol.2016 Feb;96(2):157-61. doi:10.2340/00015555-2177
American Academy of Dermatology.Nummular dermatitis: Signs and symptoms.
Jiamton S, Tangjaturonrusamee C, Kulthanan K.Clinical features and aggravating factors in nummular eczema in Thais. Asian Pac J Allergy Immunol. 2013 Mar;31(1):36-42.
U.S. National Library of Medicine.Nummular eczema. Medline Plus.
American Academy of Dermatology.Nummular dermatitis: Causes.
National Eczema Association.Nummular eczema - nummular dermatitis - discoid eczema.
American Academy of Dermatology.Nummular dermatitis: Diagnosis and treatment.
Purnamawati S, Indrastuti N, Danarti R, Saefudin T.The role of moisturizers in addressing various kinds of dermatitis: A review.Clin Med Res.2017;15(3-4):75-87. doi:10.3121/cmr.2017.1363
American Academy of Dermatology.Nummular dermatitis: Tips for managing.
Schut C, Mollanazar NK, Kupfer J, Gieler U, Yosipovitch G.Psychological interventions in the treatment of chronic itch.Acta Derm Venereol.2016 Feb;96(2):157-61. doi:10.2340/00015555-2177
Suh KS, Park JB, Yang MH, Choi SY, Hwangbo H, Jang MS.Diagnostic usefulness of dermoscopy in differentiating lichen aureus from nummular eczema.J Dermatol.2017;44(5):533-537. doi:10.1111/1346-8138.13701.
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