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DISCOID ECZEMA

What are the aims of this leaflet? 

This leaflet has been written to help you understand more about discoid eczema. It tells you what it is, what causes it, what can be done about it, and where you can find out more about it.  

What is discoid eczema?

Eczema (also called dermatitis) is a common form of inflammation affecting mainly the outer layer of the skin (the epidermis). There are several different types: in some cases the cause is understood, in others, it is not.  

Discoid means disc-shaped, and this name comes from the characteristic round or oval patches which occur in this type of eczema. For the same reason it is sometimes also called “nummular” eczema - nummular meaning coin-shaped.

Discoid eczema is most common in middle age. 

What causes discoid eczema?

The cause of discoid eczema is unknown. Similar appearances can occasionally occur in other forms of eczema, including childhood atopic eczema, eczema caused by a bacterial infection, allergic contact eczema, and irritant eczema due to repeated wear and tear, but these are not true discoid eczema. 

Like other forms of eczema, discoid eczema can be worsened by scratching, infection, and dryness of the skin.

Is discoid eczema hereditary?  

No.

What are the features of discoid eczema? 

• This is a highly inflamed type of eczema, and it is usually extremely itchy.
• It is usually worst on the limbs, but the body is often affected too. It is uncommon on the face.
• Each patch begins as a small group of red spots and tiny blisters, which enlarges rapidly into a red swollen moist round patch. This appearance may suggest an infection; however, while discoid eczema may become infected, that is not how it begins. After a while the patches become dry and scaly. A dozen or so patches may occur on each limb and on the body. Most are less than 10 centimetres (4 inches) across. Some patches may clear in the middle.
• If untreated, discoid eczema may persist for months or years, often waxing and waning, and sometimes coming back in the same sites each time.

How will it be diagnosed? 

Discoid eczema is usually diagnosed by its typical appearance and course.  Investigations may be needed to rule out other conditions: for example patch tests to look for an allergic contact eczema, or the examination of skin scales for a fungal infection. Swabs may be taken to check for a bacterial infection.

Can discoid eczema be cured? 

Discoid eczema will run its course, coming and going: but with the correct treatment it can be kept under good control.

How can it be treated? 

• Weaker steroids are inadequate for discoid eczema.  The mainstay of treatment is a strong 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.
• If infection gets in, 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, applied at a different time from the steroid, will help. This can be applied to the rest of the skin if it is dry.
• In unusually severe cases, courses of steroid tablets may be required.

Where can I get more information about discoid eczema? 

A useful article can be found on the internet at:

http://www.emedicine.com/derm/topic298.htm

The British Skin Foundation fund vital research into all skin diseases.  To find out how you can help, please visit the British Skin Foundation website here.

(While every effort has been made to ensure that the information given in this leaflet is accurate, not every treatment will be suitable or effective for every person. Your own doctor will be able to advise in greater detail. Some  medicines recommended by dermatologists are known to be useful but are not licensed for all indications, because the conditions are rare or the drug is new.)

BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET DECEMBER 2006