Coin eczema and how to treat it: the essentials about causes, symptoms and therapy

Coin eczema (nummular eczema) – one of the types of chronic itchy dermatitis and microbial eczema, accounts for about 10% of the total number of dermatoses. Large rounded plaques with clear boundaries that rise above healthy skin are a clear sign of the disease. In children, coin-like eczema practically does not occur, among adults it is approximately the same, but most often occurs at the age of 30-50 years.

Why does coin eczema occur?

Doctors cannot yet unequivocally name the cause of coin eczema. It is only known for certain that the disease always has an infectious component. At the same time, such eczema is considered polietiologic, that is, it can be caused by many different reasons. But regardless of this, in the development of dermatitis, the main role is always played by an infection that suppresses the immune system.

According to modern dermatologists, coin-like eczema is caused by a violation of immunity: cellular (it is provided by leukocytes) and humoral (antibodies are “defenders” – special proteins produced by cells). This is due to the fact that the body has a focus of chronic infection (otitis media, tonsillitis, rhinitis), to which there is excessive sensitization – increased sensitivity to the influence of irritants, causing allergies.  

The risk of experiencing coin-like eczema is increased:

  • in case of malfunctions of the nervous system;
  • changes in hormonal levels;
  • excessive sweating;
  • diabetes mellitus;
  • frequent stressful situations;
  • metabolic disorders;
  • improper diet;
  • chronic diseases of the ENT organs;
  • oral infections.

In the list of factors, you can add drugs that, against the background of a hereditary predisposition to dermatitis, reduce immunity and can cause coin-like eczema. Heredity is of no less importance in the development of the disease. If one of the parents has such a diagnosis, then the probability of its occurrence in a child is 40%, if both, then 60%.

How does coin eczema manifest?

The peculiarity of coin eczema is that the skin with such a disease is in constant readiness to interact with the irritant. Moreover, the reactions appear gradually: first, the skin reacts to one thing, and then to many different antigens.

A characteristic symptom of coin-like eczema is oval-shaped spots with a diameter of up to 3 cm. They have clear outlines and rise above the surrounding healthy skin. The spots most commonly occur on the skin of the extremities, but can spread to the upper back, shoulders, and buttocks.

The rash causes severe and sometimes unbearable itching, which interferes with normal sleep. Because of this, a person combs them, which leads to the appearance of crusts. Vesicles are located along the borders of the spots, which open, form erosion. When the inflammation subsides a little, the skin dries up and cracks form on it. With exacerbation, spots appear on the same areas.

Many are interested in the infectiousness of coin eczema. Like other types of dermatitis, it is absolutely not contagious, it is not transmitted to other people, even with close contact. Therefore, a person with such a diagnosis cannot infect anyone, and being with him is completely safe.

How is coin eczema diagnosed?

A dermatologist may suspect coin-like eczema already on the basis of external signs. For confirmation, standard studies are prescribed, including a general analysis of urine and blood, a biochemical blood test. The patient may require consultation with a neurologist, gastroenterologist, allergist and endocrinologist.

Coin eczema must be distinguished from other types of dermatitis, psoriasis, scabies, and ringworm. For this purpose, an enzyme-linked immunosorbent assay for antibodies is performed. To identify an infection, a microbiological examination of a smear from the focus of inflammation is performed. It also helps determine antibiotic sensitivity and prescribes the correct treatment. 

How to cure coin eczema

Coin eczema treatment is complex. It is necessary to take measures against the underlying disease, which is associated with a focus of chronic infection, to normalize the work of the digestive, endocrine and nervous systems. Antibiotics for coin eczema help, but often do not lead to remission, which must be achieved with such a disease.

Antibacterial drugs are often resorted to if a secondary infection has joined. In other cases, the treatment is based on:

  • sedatives, tranquilizers, antidepressants, antipsychotics, herbal teas – to relieve stress;
  • desensitizing drugs – to eliminate allergies;
  • enzymes – to improve digestion.

For the external treatment of eczema, hormonal ointments are used, which give a quick result. But before their appointment, they resort to non-hormonal agents, which include ointments and creams based on zinc. For pruritus, topical steroids show good results. Physiotherapy procedures have a beneficial effect on the skin: phonophoresis, acupuncture, UHF therapy, ozone therapy, therapeutic mud, paraffin applications.   

It is equally important to follow a diet that excludes potential allergens: citrus fruits, pickles and pickles, fried and smoked foods, red fruits, seafood, nuts, honey, chocolate. The basis of the diet should include cereals, herbs, vegetables, lactic acid drinks.

Seek help from a dermatologist

Before prescribing both treatment and diet, it is important to confirm the diagnosis. If you find suspicious rashes on your skin, be sure to see a dermatologist. The effectiveness of treatment directly depends on the correctness of the diagnosis.

event_note May 28, 2021

account_box Dr. Peter B Milburn

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