Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/discoid-eczema/treatment/

  There’s no simple cure for discoid eczema, but medicines can help to ease the symptoms. […] Treatments include: emollients to use all the time, soap substitutes to replace irritating soaps and cleaning products, topical corticosteroids for flare-ups, antibiotics for infected eczema, antihistamines for severe itching. […] A range of emollient products, soap substitutes and some topical corticosteroids can be bought from pharmacies without a prescription. […] Ask a pharmacist for advice on the different products and how to use them. See a GP if your eczema does not improve after using an over-the-counter product. […] To treat the patches of discoid eczema, a GP may prescribe a topical corticosteroid, which you apply directly to your skin, to reduce inflammation. […] There are different strengths of topical corticosteroids that can be prescribed depending on the severity of the eczema. Discoid eczema usually needs a stronger type of corticosteroid than other types of eczema.

• #2 Discoid eczema | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/discoid-eczema/

  Discoid eczema is usually a long-term problem, but medications are available to help relieve the symptoms and keep the condition under control. Treatments used include: emollients moisturisers applied to the skin to stop it becoming dry […] topical corticosteroids ointments and creams applied to the skin that can help relieve severe symptoms […] antihistamines medications that can reduce itching and help you sleep better. There is no simple cure for discoid eczema, but there are medications that can help ease the symptoms. These include: emollients to use all the time […] topical corticosteroids for flare-ups […] oral corticosteroids for severe flare-ups […] antibiotics for infected eczema […] antihistamines for severe itching. If your eczema does not improve after using an over-the-counter preparation, see your GP.

• #3 Eczema types: Nummular eczema diagnosis and treatment

  https://www.aad.org/public/diseases/eczema/types/nummular-dermatitis/treatment

  If you have nummular eczema, your dermatologist will create a treatment plan tailored to your needs. […] The main goals of treatment are to clear your skin and ease your discomfort. To do this, your treatment plan may include treatment designed to: […] Moisturizer plays a key role in healing your skin. Your dermatologist may recommend a hypoallergenic, fragrance-free moisturizing cream or ointment instead of a lotion. […] To help clear the eczema, your dermatologist will prescribe medication or light treatments. Most people will apply one of these medications: […] For some people, a light treatment called phototherapy may be an option. […] If you developed an infection, your dermatologist will prescribe medication to help clear the infection. […] If the itch keeps you awake, your dermatologist may recommend taking an antihistamine that makes you drowsy. […] With proper treatment, nummular eczema can clear completely. Self-care also plays an important role.

• #4 Discoid Eczema: Symptoms, Causes, and Treatment

  https://patient.info/skin-conditions/atopic-eczema/discoid-eczema

  Treatment includes regular use of emollients to moisturise your skin, steroid creams to reduce inflammation and treatment of any infection of the affected skin. […] Treatment is aimed at: […] Restoring fluid to your skin (called rehydration). […] Treating the skin inflammation. […] Also treating any infection that may be present. […] Regular use of emollients is the most important part of the day-to-day treatment for people with eczema, including discoid eczema. […] Emollients prevent skin from becoming dry and help to protect the skin from irritants. […] A topical steroid is a steroid cream or ointment that is applied to the skin. In discoid eczema, topical steroids are applied to the skin patches to reduce inflammation. […] Sometimes wet wrap treatments are used with a topical steroid to treat discoid eczema.

• #4 Discoid Eczema: Symptoms, Causes, and Treatment

  https://patient.info/skin-conditions/atopic-eczema/discoid-eczema

  Antibiotic medication might be needed if there is bacterial infection of discoid eczema patches. […] Antihistamine tablets may help to reduce itching and may be particularly useful at night when trying to sleep. […] Tar preparations may be helpful, especially in areas of skin that have been thickened and scaly for a long time. […] Tacrolimus and pimecrolimus are other creams that may be used to help reduce inflammation in some people with discoid eczema. […] Because discoid eczema tends to improve in the sun, ultraviolet (UV) light treatment (phototherapy) can sometimes be helpful as a treatment. […] Medicines that suppress the immune system may occasionally be needed to treat discoid eczema.

• #5 Discoid eczema. Discoid eczema

  https://dermnetnz.org/topics/discoid-eczema

  What is the treatment of discoid eczema? As discoid eczema is associated with loss of skin barrier function, it is important to: Protect the skin from injury. This type of dermatitis often starts after minor skin injuries, so careful skin protection is required. If the hands are affected, use gloves and tools to make sure the skin is not irritated by friction, detergents, solvents, other chemicals, or excessive water. Apply emollients frequently Emollients include bath oils, soap substitutes and moisturising creams. They can be applied to dermatitis as frequently as required to relieve itching, scaling, and dryness. Emollients should also be used on the unaffected skin to reduce dryness. It may be necessary to try several different products to find one that suits. Many people find one or more of the following helpful: glycerine and cetomacrogol cream, white soft paraffin/liquid paraffin mixed, fatty cream, wool fat lotions, or urea cream. Avoid allergens If patch testing has identified contact allergy, exposure to the allergen should be avoided. Anti-inflammatory treatments include: Topical steroids Topical steroids are anti-inflammatory creams or ointments available on prescription to apply just to the patches once or twice daily for 24 weeks. They may also be available as steroid impregnated tape. Topical steroids reduce symptoms and clear the dermatitis. Antibiotics Antibiotics (eg, erythromycin, flucloxacillin) are often prescribed if the dermatitis is blistered, sticky, or crusted. Sometimes discoid eczema clears completely on oral antibiotics, only to recur when they are discontinued. Other treatments sometimes prescribed for severe discoid eczema include: Oral antihistamines Antihistamine pills may reduce the itch in some patients with discoid eczema. They do not clear the rash. Ultraviolet radiation (UV) treatment Phototherapy several times weekly for 612 weeks for generalised or widespread discoid eczema can reduce itch and improve the rash. Steroid injections Intralesional steroids are sometimes injected into one or two particularly stubborn areas of discoid eczema. This treatment is unsuitable for multiple lesions. Oral steroids Systemic steroids are reserved for severe and extensive cases of discoid eczema. They are usually prescribed for a few weeks before continuing topical steroids and emollients on residual dermatitis. Other oral treatments Persistent and troublesome discoid eczema is occasionally treated with methotrexate, azathioprine or ciclosporin. These medicines require careful monitoring by a specialist dermatologist. They may be more suitable than long-term systemic steroids.

• #6 Eczema – discoid eczema

  https://www.pcds.org.uk/patient-info-leaflets/eczema-discoid-eczema

  Discoid eczema is not genetic and so does not run in families. […] Accordingly, managing the skin barrier effectively is one of the most important aspect of treating any type of eczema. […] Help repair the skin barrier with emollient moisturisers – these come in the form of creams, gels, and ointments. […] Emollients – as discussed above. You must continue using these even if the eczema is settled, otherwise your eczema is likely to flare-up more often. […] Steroid creams (or ointments, gels, lotions) should be applied thinly and only to the affected patches of skin during flare-ups. […] Treatment options can include alternative topical treatments (creams, ointments, gels), a course of light treatment (phototherapy), oral medications (tablets) to lessen the immune reaction in your skin (immunosuppressive drugs), or injections. […] Unfortunately not, and if left untreated, discoid eczema may persist for months or years.

• #7 Discoid Eczema | What’s Discoid Eczema & How Is It Treated?

  https://www.theindependentpharmacy.co.uk/eczema-dermatitis/guides/discoid-eczema

  We explain exactly what discoid eczema is, what it looks like and how you can treat it. […] There are several treatments you can use. […] The eczema treatments available range in intensity and the frequency with which they can be used, from those you can take at all times to those you must only take for a small period of time. […] Emollients are skin moisturisers. […] Emollients can come as creams, ointments or lotions. […] Topical corticosteroids (topical steroid creams) are an effective treatment for treating skin conditions where there’s inflammation, like discoid eczema. […] Over-the-counter treatments (creams, oils and ointments) can be an effective way of treating mild cases of discoid eczema. […] If you have a severe case of discoid dermatitis or your skin has become infected then you can complete an online consultation and get prescription treatment for your discoid eczema through The Independent Pharmacy.

• #8 Discoid eczema – National Eczema Society

  https://eczema.org/information-and-advice/types-of-eczema/discoid-eczema/

  How is discoid eczema treated? […] A number of medications are available from your GP to help treat discoid eczema, and there are steps you can take at home to make the skin more comfortable. […] People with discoid eczema often have dry skin that should be treated to improve the existing eczema and help prevent further flares. […] A wide range of emollients, also known as moisturisers, is available to treat dry skin. […] If areas of skin are weeping or wet (remember this may indicate infection), a cream emollient (as opposed to an ointment emollient) is more suitable. […] Once discoid eczema has developed, the skin can become itchy and red or darker than your usual skin colour, depending on skin tone. If this happens, your doctor may prescribe a steroid with a cream or ointment base to apply to the affected areas to help them clear up.

• #8 Discoid eczema – National Eczema Society

  https://eczema.org/information-and-advice/types-of-eczema/discoid-eczema/

  If your skin is infected (crusting, oozing and very inflamed), see your healthcare professional to get a specific treatment for this. […] Discoid eczema can usually be controlled with emollients and topical steroids, and by avoiding triggers such as soaps, bubble baths and overheating. […] For severe and extensive discoid eczema, other treatments may be required, such as paste bandages, immunosuppressant drugs and light therapy.

• #9 Eczema: What It Is, Symptoms, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/9998-eczema

  If your child has skin issues, such as eczema, you can: […] Give your child a short, warm bath instead of a long, hot bath, which can dry out their skin. […] Use moisturizers several times daily. In infants with eczema, moisturizing on a regular basis, like with each diaper change, is extremely helpful. […] Keep the room temperature as regular as possible. Changes in room temperature and humidity can dry your child’s skin. […] Keep your child dressed in cotton. Wool, silk and synthetic fabrics such as polyester can irritate their skin. […] Use sensitive skin or unscented laundry detergent. […] Help your child avoid rubbing or scratching at their skin. […] There are several options of moisturizer available to treat eczema. Choose skin care products that: […] Are hypoallergenic, fragrance- and dye-free.

• #9 Eczema: What It Is, Symptoms, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/9998-eczema

  Are gentle or for sensitive skin. […] Contain petroleum jelly or mineral oil. […] Don’t include preservatives or stabilizers. […] Have lipids and ceramides to improve your skin’s barrier. […] Treating and managing eczema can be difficult if the cause is something you can’t control, like genetics. […] Fortunately, you may have some influence over your environment and stress levels. […] Do your best to figure out what triggers or worsens your eczema, and then avoid it. […] The goal is to reduce itching and discomfort and prevent infection and additional flare-ups. […] After treatment, it could take several weeks before your skin clears up completely. […] Topical medications or oral medications prescribed by your healthcare provider help your symptoms go away faster. […] If your symptoms get worse after treatment, or if they don’t clear up after a few weeks, contact your provider.

• #10 Nummular eczema Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/nummular-eczema

  Apply a warm towel or wear dry clothes over the wet bandage or wet pajamas. […] Follow your provider’s instructions for how long to keep the area covered, and how many times a day to do the wet wrap treatment. […] The following measures may help improve your symptoms or prevent them from returning if your skin has cleared: […] Use lukewarm water when bathing and showering. Hot water can dry and irritate the skin. Take shorter or fewer baths or showers. […] Don’t use soap. It can dry the skin. Use a gentle, mild cleanser instead. […] Ask your provider about adding bath oil to bath water. […] After bathing or showering, pat the lesions dry and apply lotion before the skin is all dry. […] Wear loose clothing. Tight clothing can rub and irritate the skin. Avoid wearing rough fabrics, such as wool, next to the skin. […] Use a humidifier in your home to help moisten the air.

• #10 Nummular eczema Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/nummular-eczema

  Eczema is often treated with medicines applied to the skin. These are called topical medicines, and may include: […] A mild cortisone (steroid) cream or ointment at first. You may need a stronger medicine if this does not work. […] Other ointments or creams that help quiet the immune response may be prescribed for anyone over 2 years old, often for use on the face or other sensitive areas. […] Creams or ointments that contain coal tar may be used for thickened areas. […] You may also be asked to try a wet wrap treatment. This involves the following steps: […] Apply petroleum jelly (such as Vaseline) or corticosteroid ointment to the lesions. […] Wrap the affected area with wet bandages to keep the skin moist. This also helps the medicine work. If larger areas of the body are affected, you can wear damp pajamas or a sauna suit.

• #11 Atopic Dermatitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0515/p590.html

  Emollients should be used as the primary therapy for atopic dermatitis flare-ups and maintenance. […] Once-daily bathing with lukewarm water that is limited to five to 10 minutes is recommended for patients with atopic dermatitis. […] Topical corticosteroids should be used as first-line treatment for atopic dermatitis flare-ups. […] Topical calcineurin inhibitors may be used as first-line treatment for moderate to severe atopic dermatitis in combination with topical steroids. […] Ultraviolet B phototherapy should be used as second-line treatment for moderate to severe atopic dermatitis. […] There is no high-quality evidence supporting oral antibiotics for prophylaxis, and they should be used only to treat secondary bacterial infections. […] Topical corticosteroids, which are the first-line treatment for atopic dermatitis flare-ups, decrease the inflammatory immune response.

• #11 Atopic Dermatitis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0515/p590.html

  Topical calcineurin inhibitors are steroid-sparing immunomodulators used to treat atopic dermatitis in patients two years and older. […] Narrow band ultraviolet B phototherapy is an effective second-line treatment for moderate to severe atopic dermatitis. […] Systemic immunomodulators, including cyclosporine and azathioprine, are off-label options if standard therapy is ineffective. […] There is no high-quality evidence supporting prophylactic use of oral antibiotics. […] Crisaborole is a topical, steroid-sparing phosphodiesterase-4 inhibitor that was FDA-approved in 2016 to treat mild to moderate atopic dermatitis in patients two years and older. […] Dupilumab is an injectable monoclonal antibody that was FDA-approved in 2017 to treat moderate to severe atopic dermatitis in patients 12 years and older who had an inadequate response or could not tolerate standard therapy. […] Poor adherence to treatment is a major factor affecting treatment outcomes in patients with atopic dermatitis.

• #12 Causes and Treatments for Discoid Eczema Patches

  https://www.verywellhealth.com/discoid-eczema-4690542

  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. […] 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. […] Medication options for discoid eczema include topical steroids, antibiotics, topical calcineurin inhibitors, antihistamines, and moisturizers. […] Topical steroids are 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.

• #12 Causes and Treatments for Discoid Eczema Patches

  https://www.verywellhealth.com/discoid-eczema-4690542

  Topical calcineurin inhibitors (TCIs) are a group of medications that include Elidel (pimecrolimus) and tacrolimus. These medications are approved for use in atopic dermatitis but are also sometimes prescribed for discoid eczema. […] Oral antibiotics may be prescribed if your eczema patches are infected, or if your discoid eczema is very severe. […] Antihistamines are 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. […] Moisturizers should 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) inhibitors include Eucrisa (crisaborole) and Zoryve (roflumilast). They have been FDA-approved for use in atopic dermatitis but may be prescribed for discoid eczema.

• #13 Nummular discoid eczema | Right Decisions

  https://rightdecisions.scot.nhs.uk/dermatology-pathways/nummular-discoid-eczema/?organization=national

  The condition can respond poorly to treatment compared to other forms of eczema, and typically requires the use of potent topical steroids. […] Advise patient on the avoidance of irritants (e.g. soap). […] Prescribe generous amounts of emollients; advise frequent and liberal use. […] Moderate potency topical corticosteroids eg. betamethasone valerate 0.025% or clobetasone butyrate 0.05%. […] Prescribe generous amounts of emollients; advise frequent and liberal use. […] Potent topical corticosteroids eg. betamethasone valerate 0.1% or mometasone 0.1%. If no improvement, may require the use of clobetasol propionate 0.05% (super potent) daily for up to 2 weeks, then review (trunk and limbs, not face and flexures). […] Other treatments may be required, such as phototherapy or oral immunosuppressant drugs.

• #14 Nummular discoid eczema | Right Decisions

  https://rightdecisions.scot.nhs.uk/dermatology-pathways/nummular-discoid-eczema/?UNLID=383433117202411631832

  The condition can respond poorly to treatment compared to other forms of eczema, and typically requires the use of potent topical steroids. […] Advise patient on the avoidance of irritants (e.g. soap). […] Prescribe generous amounts of emollients; advise frequent and liberal use. […] Moderate potency topical corticosteroids eg. betamethasone valerate 0.025% or clobetasone butyrate 0.05%. […] Prescribe generous amounts of emollients; advise frequent and liberal use. […] Potent topical corticosteroids eg. betamethasone valerate 0.1% or mometasone 0.1%. If no improvement, may require the use of clobetasol propionate 0.05% (super potent) daily for up to 2 weeks, then review (trunk and limbs, not face and flexures). […] Refer to dermatologist. Commence treatment in primary care whilst waiting for appointment. […] Super potent topical corticosteroids eg. clobetasol propionate 0.05% daily for up to 2 weeks, then review (trunk and limbs, not face and flexures). […] Other treatments may be required, such as phototherapy or oral immunosuppressant drugs.

• #15 Nummular Dermatitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK565878/

  Nummular dermatitis is recognized as discoid eczema or nummular eczema, which manifests as pruritic, coin-shaped lesions, commonly affecting the extremities and occasionally the trunk. […] Effective management predominantly involves conservative measures and the application of topical corticosteroids, resulting in substantial remission for most patients. […] The management of nummular dermatitis focuses on restoring the natural skin barrier and avoiding behaviors that dry and irritate the skin. […] Frequent moisturization with thick emollients such as petroleum jelly is recommended. […] High- or ultrahigh potency (classes I-III) topical corticosteroids applied directly to affected skin 1 to 2 times daily help decrease inflammation and pruritus. […] Topical calcineurin inhibitors (tacrolimus, pimecrolimus) may be used as steroid-sparing topical agents.

• #15 Nummular Dermatitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK565878/

  For widespread disease in which topical treatment may not be feasible, narrowband UVB light therapy should be considered. […] If light therapy is not available, systemic immunosuppressants and immunomodulators have been used to treat extensive recalcitrant disease. […] Oral prednisone can be initiated at 40 mg per day, with the dose reduced by 10 mg every 5 days before being discontinued. […] Dupilumab, an IL-4 and IL-13 inhibitor, has been reported as effective in several small series of patients with nummular eczema. […] Most nummular dermatitis cases should respond to conservative measures such as gentle skincare and bland emollients used in combination with mid- to high-potency steroids.

• #16 Discoid Eczema – Sussex Community Dermatology Service

  https://sussexcds.co.uk/patient-information/discoid-eczema/

  Can discoid eczema be cured? No, treatment controls the condition but does not cure it. […] How can it be treated? Mild steroids are inadequate for discoid eczema. The mainstay of treatment is a potent steroid cream or ointment. This should be applied once or twice daily (depending on which topical steroid has been prescribed) to all affected areas, avoiding the normal skin, until the inflammation is completely suppressed. Treatment should restart at the first sign of recurrence. […] Other non-steroid creams such as tacrolimus ointment or pimecrolimus cream can be helpful. […] If infection occurs an antibiotic will be necessary, either included in the steroid application or as tablets. […] The surface of chronic patches is dry and scaly, and an emollient (moisturising) cream or ointment is essential. This should also be applied to the unaffected skin, especially if it is dry. The emollient should be continued indefinitely, even after the patches have cleared up and the steroid cream has been discontinued. […] In more severe cases, courses of steroid tablets may rarely be required. Occasionally, ultraviolet light treatment may be considered by your doctor.

• #17 Discoid eczema – Hoogstra – Medical Centers

  https://doctorhoogstra.com/en/wiki/eczema-discoid/

  Anti-inflammatory treatments include: […] Current steroids Topical steroids are anti-inflammatory creams or ointments available by prescription that can clear dermatitis and reduce irritation. The strongest products are applied to the patches only once or twice a day for 2 to 4 weeks. They repeat from time to time. Mild ones like hydrocortisone are safe for daily use if needed. […] Antibiotics Antibiotics (most often flucloxacillin) are often prescribed if the dermatitis is blistering, sticky, or crusty. Sometimes discoid eczema clears up completely with oral antibiotics, only to recur when they are stopped. […] Other treatments sometimes prescribed for severe discoid eczema include: […] Oral antihistamines Antihistamine pills can reduce itching in some patients with discoid eczema. They do not lighten the rash.

• #17 Discoid eczema – Hoogstra – Medical Centers

  https://doctorhoogstra.com/en/wiki/eczema-discoid/

  Ultraviolet radiation (UV) treatment Phototherapy several times a week for 6 to 12 weeks can reduce the extent and severity of discoid eczema. […] steroid injections Intralesional steroids are sometimes injected into one or two particularly difficult areas of discoid eczema. This treatment is not suitable for multiple injuries. […] oral steroids Systemic Steroids are reserved for severe and extensive cases of discoid eczema. They are usually prescribed for a few weeks while continuing steroid creams and emollients in residual dermatitis. […] Other oral treatments Persistent and troublesome discoid eczema is occasionally treated with methotrexate, azathioprine, or cyclosporine. These medications have significant risks and side effects and require careful monitoring by a specialist. dermatologist. They may be more suitable in many cases than steroids in the long term. […] Discoid eczema can usually be controlled with the above measures, although it tends to recur when treatment is stopped. In most patients, discoid eczema eventually clears up completely.

• #18 Nummular Dermatitis (Nummular Eczema) Treatment & Management: Approach Considerations, Medical Care, Activity

  https://emedicine.medscape.com/article/1123605-treatment

  Use of hypoallergenic, fragrance-free creams, lotions, or ointments is the first step in therapy. The medications and emollients employed for this purpose are best absorbed by dampening the skin first. […] Lukewarm or cool baths or showers reduce itching and help rehydrate the skin; a gentle soap or liquid cleanser may be used. Skin should be patted dry and then moisturizers are applied to still-damp skin. […] The „soak-and-smear” therapeutic regimen includes a 20-minute plain water soak each night followed by application of steroid ointment or petrolatum to wet skin, along with alteration of cleansing habits so that soap is applied only to the axilla and groin. […] Wet wrap treatments are often helpful. This involves dampening the skin with lukewarm water until it is well hydrated (usually 10 min). Then, petrolatum or steroid ointment is applied liberally, followed by occlusion for 1 hour with damp pajamas or a nonbreathable sauna suit.

• #18 Nummular Dermatitis (Nummular Eczema) Treatment & Management: Approach Considerations, Medical Care, Activity

  https://emedicine.medscape.com/article/1123605-treatment

  Topical application of steroids is the therapy most commonly used to reduce inflammation. […] In cases of severe, generalized eruptions, oral, intramuscular, or parenteral steroids may be required. […] Tar preparations are helpful for decreasing inflammation, particularly in older, thickened, scaly plaques. […] Topical immune modulators (tacrolimus and pimecrolimus) also reduce inflammation. […] When eruptions are generalized and prolonged, more aggressive therapy is warranted. Systemic steroids have long been a mainstay for the treatment of dermatitis, including nummular eczema, though they should be used only in short courses and only when topical treatment has been insufficient. […] Phototherapy (generally with ultraviolet [UV] B) may be helpful. […] Oral immunosuppressive agents may help to attenuate the immune response; methotrexate has been used successfully in children with nummular eczema.

• #18 Nummular Dermatitis (Nummular Eczema) Treatment & Management: Approach Considerations, Medical Care, Activity

  https://emedicine.medscape.com/article/1123605-treatment

  Dupilumab, a monoclonal antibody targeting interleukin (IL)-4 and IL-13, has also been successfully used to treat nummular eczema. […] Oral antihistamines or sedatives may help reduce itching and improve sleep. […] Topical antibiotics (eg, mupirocin) may help with impetiginization. […] Once the eruption has resolved, ongoing aggressive hydration may decrease the frequency of flares, particularly in dry climates. Heavy moisturizers (preferably a sensitive-skin formulation) or petroleum jelly applied to damp skin after showering may be helpful. […] Disease may be severe and refractory to the above treatments. Immune-suppressive medications have been described as safe and effective in severely affected patients.

• #19 Nummular Dermatitis (discoid eczema) – Medika Life : Eczema Resources

  https://medika.life/nummular-dermatitis-discoid-eczema/

  Nummular dermatitis treatment […] Like atopic dermatitis, nummular eczema (nummular dermatitis) benefits from moisturizers to calm and protect the damaged skin barrier. […] In many cases, you may receive a prescription for a steroid medication to calm the inflammation as well. For some reason, the milder and moderate-potency steroid creams may not be of much help with nummular eczema (nummular dermatitis). More powerful steroid creams are frequently required. Fortunately, nummular eczema (nummular dermatitis) tends to disappear completely after the right treatment. […] In cases where steroids are not appropriate, or when you have used them for a long time, your doctor may prescribe phototherapy, coal-tar creams, or a non-corticosteroid topical medication such as tacrolimus (Protopic) or pimecrolimus (Elidel). These medications are called topical calcineurin inhibitors (TCIs) are approved for use by adults and children two years of age or older. […] Topical or oral antibiotics may be used when there is a bacterial infection on the skin. In very severe cases, systemic steroids (taken by mouth or given by injection) may be used for a short time to calm symptoms, though they are not recommended.

• #20 Discoid eczema – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/discoid-eczema/

  Discoid eczema can occur at any age but is seen more frequently in adults. […] The mainstay of treatment is a potent or very potent steroid cream or ointment. This should be applied as prescribed to all affected areas, avoiding the surrounding normal skin, until the redness and swelling subsides. […] Combination creams or ointments with steroid and antibiotics or antiseptics may be useful. […] Other prescribed non-steroid creams such as tacrolimus ointment or pimecrolimus cream may also be helpful to reduce inflammation. […] If infection occurs an antibiotic may be necessary, either as a combined preparation with the topical steroid or in tablet form. […] An emollient (moisturising) cream or ointment is usually helpful. […] Occasionally, ultraviolet light treatment may be recommended by your dermatologist. […] Persistent and troublesome discoid eczema is occasionally treated with immunosuppressant medications such as methotrexate, azathioprine, or ciclosporin. […] Immunomodulators such as dupilumab, tralokinumab or JAK (Janus Kinase) inhibitors, may be considered by a specialist.

• #21 Discoid (nummular) eczema – Clinical Tree

  https://clinicalpub.com/discoid-nummular-eczema/

  Discoid eczema (nummular dermatitis) has many causes. […] The management of discoid eczema is generally similar to that of other eczemas; emollients appear to be helpful due to the link with dry skin. […] The mainstay of treatment is topical corticosteroids. Severe itch in discoid eczema usually dictates that strong agents are applied; this is safe because the individual lesions are small, rarely affect thin skin sites such as the face or flexures, and usually respond to this approach. […] Chronic lichenified lesions may respond better to steroid-impregnated tapes or by using a potent steroid with hydrocolloid dressing or paste bandage occlusion. […] Calcineurin antagonists have been used successfully both as monotherapy and in combination with topical steroids, but trials specifically looking at efficacy in discoid eczema exclusively, rather than atopic eczema generally, are lacking.

• #21 Discoid (nummular) eczema – Clinical Tree

  https://clinicalpub.com/discoid-nummular-eczema/

  If weeping is present, the use of soaks (with, e.g., 1 in 10,000 potassium permanganate solution) will help dry lesions up and prevent lesions from sticking to clothes or dressings. […] Secondary impetiginization, particularly in the exudative phase, is common, and combining with a topical antibiotic or antiseptic, or the use of an oral antistaphylococcal antibiotic, helps. […] Tar-based treatments and impregnated bandages to minimize the effects of scratching may help. […] Sedating antihistamines before retiring will help nocturnal scratching and minimize excoriation. […] Phototherapy and systemic immunosuppressive therapies are usually not required, but there is a literature relating to ultraviolet B (UVB) and methotrexate. […] Newer drugs such as biological agents (dupilumab) and small molecules such as apremilast and topical PDE 4 antagonists, and Janus kinase (JAK) inhibitors show efficacy in atopic eczema, but specific reports relating to discoid eczema are lacking to date.

• #22

• #23

  https://www.nhs.uk/conditions/discoid-eczema/treatment/

  If your eczema becomes infected, you may also be prescribed an antibiotic. […] Antihistamines may be prescribed during flare-ups of discoid eczema to cope with the symptom of itching, particularly if it’s interfering with your sleep. […] If the treatments prescribed by a GP are not successfully controlling your symptoms, they may refer you for assessment and treatment by a doctor who specialises in skin conditions (dermatologist).

• #24

  https://111.wales.nhs.uk/encyclopaedia/e/article/eczema(discoid)

  Discoid eczema is usually a long-term problem, but medicines are available to help relieve the symptoms and keep the condition under control. […] Treatments include: emollients moisturisers applied to the skin to stop it becoming dry, topical corticosteroids ointments and creams containing a steroid that are applied to the skin and may relieve severe symptoms, antihistamines medicines that can reduce itching. […] There is no simple cure for discoid eczema, but medicines can help to ease the symptoms. […] Treatments include: emollients to use all the time, soap substitutes to replace irritating soaps and cleaning products, topical corticosteroids for flare-ups, antibiotics for infected eczema, antihistamines for severe itching. […] If your eczema becomes infected, you may also be prescribed an antibiotic.

• #24

  https://111.wales.nhs.uk/encyclopaedia/e/article/eczema(discoid)

  If you have an extensive area of infected eczema, you may be prescribed an antibiotic to take by mouth. […] If you have a small amount of infected eczema, you will usually be prescribed a topical antibiotic, such as fusidic acid. […] Antihistamines may be prescribed during flare-ups of discoid eczema to cope with the symptom of itching, particularly if it is interfering with your sleep. […] If the treatments prescribed by a GP are not successfully controlling your symptoms, they may refer you for assessment and treatment by a doctor who specialises in skin conditions (dermatologist).

• #25 Discoid Eczema (Nummular): Symptoms and Treatment | Doctor

  https://patient.info/doctor/discoid-nummular-eczema

  If there is secondary infection then antibiotics are required. Oral antibiotics, effective against staphylococci and streptococci, should be used. […] Antihistamines can reduce pruritus and aid sleep. As the pruritus is not a direct effect of histamine, the sedative effect is more important than the antihistamine action and so the older, sedating ones are needed. A higher dose at night will aid sleep. […] Tar preparations may reduce inflammation, particularly in older, thickened, scaly plaques. […] After the eruption has resolved, continue aggressive hydration to reduce the frequency of attacks, especially in dry climates. Moisturisers for sensitive skin may be applied or petroleum jelly applied to damp skin after showering. […] Resting in a cool, moist environment helps, whilst a hot dry environment aggravates the problem.

• #25 Discoid Eczema (Nummular): Symptoms and Treatment | Doctor

  https://patient.info/doctor/discoid-nummular-eczema

  Sunlight or phototherapy may benefit chronic cases. Ultraviolet radiation helps reduce the inflammatory activity within the skin but there is risk of heat worsening the pruritus and ultraviolet light has its own problems, including carcinogenesis. […] In severe cases, immunosuppressant drugs such as methotrexate, azathioprine or ciclosporin may be used.

• #26 Discoid eczema – more than just dermatitis | Medicine Today

  https://medicinetoday.com.au/mt/2021/may/feature-article/discoid-eczema-%E2%80%93-more-just-dermatitis

  For widespread disease, alternative treatment therapies include narrowband UVB light therapy two to three times weekly, with duration titrated to treatment response. […] Systemic immunosuppressants and immunomodulators have been used as more last-line options for extensive disease. […] Dupilumab is an emerging treatment option for recalcitrant discoid eczema. […] Patients with the exudative subtype of discoid eczema may benefit from an oral antibiotic such as cefalexin, clarithromycin or a tetracycline. […] Secondary bacterial infections should be treated with topical or oral antistaphylococcal antibiotics depending on the size and distribution of the lesions, with further treatment based on bacterial swab results and local antibiotic resistance. […] Referral to a dermatologist is appropriate if the disease does not respond to conservative skin care measures, bland emollients, topical corticosteroids and antibiotics.

• #27 Nummular Dermatitis (Nummular Eczema): Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1123605-overview

  Treatment includes moisturizers and topical steroids. If there is an overt infection, a combination of a topical antibiotic and a steroid ointment may be used. Nighttime use of antihistamines can help with sleep. Severe or generalized flares may be treated with dressings on top of the steroid ointment. Oral or parenteral steroids may be used in severe flares, followed by topical therapy. Oral antibiotics, such as dicloxacillin, cephalexin, or erythromycin, should be used in cases of secondary infection. […] Once the lesions develop, use of topical steroids or calcineurin inhibitors helps with the itch and hastens resolution.

• #28 What Is Nummular Eczema? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/eczema/nummular-eczema.aspx

  Nummular eczema usually clears up completely with the right treatment. However, it rarely improves without relatively aggressive treatment. […] Nummular eczema is typically treated with a mid- or high-potency topical corticosteroid, along with a topical antibiotic. […] These will clear the rash quickly, says Friedler. They will also help reduce inflammation and itching. […] For significantly weepy and oozy eczema patches, an astringent compress can also be used to dry up the skin and help clear up any staph infection. […] While having one or a few patches of nummular eczema makes you a good candidate for a topical cream, if you have a widespread or severe case, your dermatologist may talk to you about a treatment called phototherapy, Guttman says. […] Phototherapy is light therapy that directs controlled wavelengths of ultraviolet (UV) light to the skin to reduce itchiness and inflammation.

• #28 What Is Nummular Eczema? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/eczema/nummular-eczema.aspx

  Phototherapy treatments penetrate the outer layers of skin and reduce inflammatory cells, Guttman says. […] These treatments may be used all over skin, or a specific type of laser called an excimer laser can be used to target affected areas only, she adds. […] Phototherapy may also be recommended if four weeks of topical treatment and proper skin care do not clear the coin-shaped patches, Guttman says. […] Part of the treatment for nummular eczema will generally be gentle skin care, says Friedler. […] To prevent future flare-ups of nummular eczema, practice smart skin-care tips, such as routine use of moisturizer, short showers, and use of a humidifier on cold, dry days to prevent dry skin. […] If nummular eczema is caused by a contact allergy, avoid the triggering allergen to prevent a flare-up. […] Once nummular eczema is treated, it often disappears completely, and for people who don’t have another type of eczema, it often never occurs again.

• #29 Discoid Eczema – Symptoms, Causes, Treatments

  https://resources.healthgrades.com/right-care/eczema/discoid-eczema

  Treatment strategies include: […] Generous use of skin emollients […] Limiting exposure to your specific environmental triggers […] Using a perfume-free moisturizer daily on all your skin (not just the affected spots), whether you are experiencing a flare-up or not […] Using mild soaps to help prevent and minimize flare-ups. […] A number of medications may be used including: […] Antihistamines, such as cetirizine hydrochloride (Zyrtec), diphenhydramine (Benadryl), fexofenadine (Allegra), hydroxyzine (Vistaril), and loratadine (Claritin) […] Oral corticosteroids (for severe cases only), such as prednisone (Deltasone), prednisolone (Delta-Cortef, Prelone), and methylprednisolone (Medrol) […] Phototherapy (therapeutic UV light exposure) […] Topical corticosteroids, such as hydrocortisone cream (Cort-Dome, Dermacort, Hytone, Synacort), betamethasone dipropionate (Diprosone), flurandrenolide (Cordran), fluticasone propionate (Cultivate), and triamcinolone acetonide (Aristocort, Kenalog). High- and very high-strength corticosteroids include betamethasone dipropionate (Diprosone, Diprolene), fluocinonide (Lidex), triamcinolone (Kenalog), and clobetasol propionate (Temovate)

• #29 Discoid Eczema – Symptoms, Causes, Treatments

  https://resources.healthgrades.com/right-care/eczema/discoid-eczema

  Topical immune modulators (tacrolimus, pimecrolimus) […] Topical tar preparations. […] In addition to having an integrated treatment plan that includes lifestyle strategies and medications, you can also reduce your symptoms by: […] Avoiding chlorinated swimming pools, saunas, and hot tubs […] Being careful to avoid over-washing or scrubbing the skin […] Taking an oatmeal bath or using oatmeal soap to relieve itch […] Using a home humidifier […] Using ice bags or cool, wet compresses to relieve itch.

• #30 Discoid eczema: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/182794

  If commercial products do not work, a doctor or pharmacist can advise about alternatives. Various OTC medications are available, including shampoos, emollient products, and some low dose topical steroids. […] Artificial ultraviolet A (UVA) or UVB light therapy may help reduce symptoms. This therapy involves the targeted application of concentrated UV light to affected areas. People with eczema may require multiple phototherapy treatments to get the best possible results. […] Using emollient ointments, maintaining good hygiene practices, and avoiding triggers can help people manage discoid eczema at home. In severe cases, doctors may recommend medical treatments, such as prescription ointments, steroid treatments, or phototherapy.

• #31 Atopic dermatitis (eczema) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279

  For more-severe eczema, your health care provider may prescribe pills to help control your symptoms. Options might include cyclosporine, methotrexate, prednisone, mycophenolate and azathioprine. […] The injectable biologics (monoclonal antibodies) dupilumab (Dupixent) and tralokinumab (Adbry) might be options for people with moderate to severe disease who don’t respond well to other treatment. Studies show that it’s safe and effective in easing the symptoms of atopic dermatitis. […] An effective, intensive treatment for severe eczema involves applying a corticosteroid ointment and sealing in the medication with a wrap of wet gauze topped with a layer of dry gauze. […] The simplest form of light therapy (phototherapy) involves exposing the affected area to controlled amounts of natural sunlight. Other forms use artificial ultraviolet A (UVA) and narrow band ultraviolet B (UVB) alone or with drugs. […] If you’re embarrassed or frustrated by your skin condition, it can help to talk with a therapist or other counselor. […] These approaches may help people who scratch out of habit.

• #32

  https://www.grahamsnatural.com/blogs/news/understanding-discoid-eczema-causes-symptoms-treatment?srsltid=AfmBOooTW5bt8w0NSXmOqEwIlylVSNmq08p_D-beWglgTli5QIFp4HYq

  Phototherapy: In some cases, phototherapy, also known as light therapy, may be recommended. This treatment involves exposing the affected skin to controlled amounts of ultraviolet (UV) light, which can help reduce inflammation and itching. […] Gentle Skincare Routine: Use mild, fragrance-free cleansers and moisturizers specifically formulated for sensitive skin. Avoid harsh soaps or products that may further irritate the skin. All of the Grahams Natural range is soap, SLS, chemical fragrance free! […] Avoid Scratching: Although the itchiness can be unbearable, scratching can worsen the condition and lead to complications. Keep nails short, and consider using anti-itch creams or cold compresses to alleviate the itch. […] Stress Management: Implement stress reduction techniques such as meditation, yoga, or engaging in hobbies that promote relaxation. Managing stress can help prevent flare-ups and improve overall well-being. […] Clothing Choices: Opt for loose-fitting, breathable clothing made from natural fibers like cotton. This allows the skin to breathe and reduces friction that can worsen symptoms.

• #33 Nummular Eczema: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/skin/nummular-eczema

  There is no cure for nummular eczema. However, you may be able to manage your symptoms with certain lifestyle measures and by avoiding triggers. […] Doctors may recommend avoiding: wool or other irritants that may trigger your symptoms, excessive bathing and hot water, harsh soaps, stressful situations, environmental irritants, such as household cleaners and chemicals, scrapes, cuts, and abrasions on the skin. […] The following can help relieve your eczema: using moist bandages to cover and protect affected areas, taking antihistamines to relieve itching and discomfort, applying medicated lotions or skin ointments, such as corticosteroids, getting ultraviolet light treatment for severe itching, hydrating skin with a non-scented moisturizer after showering, moisturizing daily, using unscented fabric softener and dryer sheets. […] With the proper treatment and management, nummular eczema may improve or go away.

• #34 Nummular Eczema: Causes, Symptoms, Treatment | National Eczema Association

  https://nationaleczema.org/eczema/types-of-eczema/nummular-eczema/

  Other treatments to manage symptoms include wet wraps, antihistamines, a humidifier, topical steroids and non-steroidal medications, and eczema-friendly cleansers and moisturizers designed for sensitive skin. […] Nummular eczema symptoms often clear after treatment, usually within three to four weeks. There are some signs that your eczema flare is responding well to treatment. The most obvious sign is that the nummular eczema lesions begin to flatten. The center of the red spot often clears first, creating a ring instead of a fully formed circle. Eventually, the entire red spot will disappear. Sometimes it’s replaced by a flat dark spot. This discoloration is more likely in darker skin tones and is not a sign of an active nummular eczema flare. […] If you believe your nummular eczema is infected, consult with your dermatologist or primary care provider as soon as possible. They will likely have to prescribe medication to help your body overcome the infection.

• #35 Nummular Eczema: An Updated Review – PubMed

  https://pubmed.ncbi.nlm.nih.gov/32778043/

  Nummular eczema should be distinguished from other annular lesions. […] Avoidance of precipitating factors, optimal skin care, and high or ultra-high potency topical corticosteroids are the mainstay of therapy. […] With proper treatment, nummular eczema can be cleared over a few weeks, although the course can be chronic and characterized by relapses and remissions.

• #36 Nummular Eczema Symptoms and Treatment

  https://www.wederm.com/patient-library/nummular-eczema/

  Nummular eczema treatment […] Nummular eczema is typically more stubborn than other forms of eczema and rarely goes away without treatment. Topical eczema medications are the most common treatment. They include corticosteroid ointment, tar cream, tacrolimus ointment and pimecrolimus cream. These medications reduce itching and inflammation. […] If the lesions are widespread, your dermatologist might recommend an oral or injectable corticosteroid, which is stronger than topical corticosteroids. Phototherapy, also called ultraviolet light therapy, is another treatment option for some people.

• #37 Treatment of discoid eczema – Dr. Breslavets

  https://cmsderm.ca/treatment-of-discoid-eczema/

  Antihistamine pills can help to reduce the itch in some cases of discoid eczema. However, they do not clear the rash. […] Phototherapy treatment sessions can be prescribed for the course of 6-12 weeks for generalised or widespread discoid eczema. It helps to reduce the itch and improve the rash. […] Intralesional steroids can be injected into a few stubborn areas of discoid eczema, but this occurs quite rarely. This treatment is not suitable for multiple lesions. […] Systemic steroids are recommended for only severe and extensive cases of discoid eczema. They are usually prescribed for a few weeks before continuing topical steroids and emollients on residual dermatitis. […] Persistent and troublesome cases of discoid eczema are treated with ciclosporin, methotrexate, or azathioprine. These medications have to be carefully monitored by a specialist dermatologist. They may be more suitable in comparison with long-term systemic steroids. […] Discoid eczema can transition into a chronic condition that often relapses during cold winter months. Many cases tend to resolve with time. […] Centre for Medical and Surgical Dermatology offers unique and personalized treatment options for discoid eczema for each patient.

Zobacz więcej