{"id":477,"date":"2023-01-02T17:29:23","date_gmt":"2023-01-02T22:29:23","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/?post_type=chapter&#038;p=477"},"modified":"2023-01-10T17:23:49","modified_gmt":"2023-01-10T22:23:49","slug":"nummular-eczema-nummular-dermatitis","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/chapter\/nummular-eczema-nummular-dermatitis\/","title":{"raw":"Nummular Eczema\/ Nummular Dermatitis","rendered":"Nummular Eczema\/ Nummular Dermatitis"},"content":{"raw":"<h1>What is it?<\/h1>\r\nNummular dermatitis is a form of eczema characterized by coin-shaped eczematous plaques that can occur as a solitary plaque or can be multiple and widespread.\r\n<h1>What does it look like?<\/h1>\r\nNummular dermatitis is round to oval in shape and is intensely itchy. They are seen most commonly on the extremities and usually measure only 1-3 cm in diameter. They have minute papules and vesicles that are seen within the plaque. Unlike tinea corporis, which is annular in morphology, the skin changes are not accentuated at the periphery but involve the entire lesion. Early on, they may be quite inflamed with vesicles and weeping. Given the intense itching which causes frequent scratching and rubbing, they are often seen to be lichenified and have associated pigmentary change if they have been present for a long time.\r\n<h1>How is it treated?<\/h1>\r\nTreatment requires mid\u2013 to high\u2013 potency corticosteroids. In early lesions, it may be possible to clear with betamethasone valerate or mometasone furoate cream or ointment.\u00a0 Once lichenification has occurred, however, it is usually necessary to use a high potency corticosteroid such as clobetasol proprionate or betamethasone diproprionate. Several days of corticosteroid under occlusion may also be helpful.\u00a0 The occlusion is best achieved by applying the medication then covering the area with plastic wrap, which can be held in place by tape or a sock, or with a plastic band-aid. Secondary bacterial infection is common and antibacterials should be considered if the plaques are crusted.\r\n\r\n[caption id=\"attachment_457\" align=\"aligncenter\" width=\"300\"]<img class=\"size-medium wp-image-457\" src=\"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" \/> Image 3.14: Nummular eczema[\/caption]","rendered":"<h1>What is it?<\/h1>\n<p>Nummular dermatitis is a form of eczema characterized by coin-shaped eczematous plaques that can occur as a solitary plaque or can be multiple and widespread.<\/p>\n<h1>What does it look like?<\/h1>\n<p>Nummular dermatitis is round to oval in shape and is intensely itchy. They are seen most commonly on the extremities and usually measure only 1-3 cm in diameter. They have minute papules and vesicles that are seen within the plaque. Unlike tinea corporis, which is annular in morphology, the skin changes are not accentuated at the periphery but involve the entire lesion. Early on, they may be quite inflamed with vesicles and weeping. Given the intense itching which causes frequent scratching and rubbing, they are often seen to be lichenified and have associated pigmentary change if they have been present for a long time.<\/p>\n<h1>How is it treated?<\/h1>\n<p>Treatment requires mid\u2013 to high\u2013 potency corticosteroids. In early lesions, it may be possible to clear with betamethasone valerate or mometasone furoate cream or ointment.\u00a0 Once lichenification has occurred, however, it is usually necessary to use a high potency corticosteroid such as clobetasol proprionate or betamethasone diproprionate. Several days of corticosteroid under occlusion may also be helpful.\u00a0 The occlusion is best achieved by applying the medication then covering the area with plastic wrap, which can be held in place by tape or a sock, or with a plastic band-aid. Secondary bacterial infection is common and antibacterials should be considered if the plaques are crusted.<\/p>\n<figure id=\"attachment_457\" aria-describedby=\"caption-attachment-457\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-457\" src=\"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-300x225.jpg 300w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-1024x768.jpg 1024w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-768x576.jpg 768w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-1536x1152.jpg 1536w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-2048x1536.jpg 2048w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-65x49.jpg 65w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-225x169.jpg 225w, https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-content\/uploads\/sites\/1779\/2022\/12\/nummular-eczema-1-edit-350x263.jpg 350w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-457\" class=\"wp-caption-text\">Image 3.14: Nummular eczema<\/figcaption><\/figure>\n","protected":false},"author":1682,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-477","chapter","type-chapter","status-publish","hentry"],"part":407,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/477","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/users\/1682"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/477\/revisions"}],"predecessor-version":[{"id":1318,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/477\/revisions\/1318"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/parts\/407"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapters\/477\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/media?parent=477"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/pressbooks\/v2\/chapter-type?post=477"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/contributor?post=477"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pedsdermprimer\/wp-json\/wp\/v2\/license?post=477"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}