Nummular Dermatitis Part II
There are several risk factors that have been show to increase the probability of developing nummular dermatitis or increasing its severity when nummular dermatitis is already present. Prior medical conditions, such as xerosis (very dry skin) or eczema, particularly atopic dermatitis and stasis dermatitis increase the likelihood of developing nummular dermatitis, as does having poor blood circulation and/or swelling of the legs. Colder temperatures and low-humidity environments can also increase a person’s risk of developing nummular dermatitis, and these environmental factors can also significantly aggravate existing nummular dermatitis symptoms. Injuries to the skin, such as insect bites, burns or contacts with chemicals, and bacterial infections can also trigger an eruption of nummular dermatitis. Some prescription medications used to treat unrelated conditions also seem to increase the risk of developing nummular dermatitis. For example, Isotretinoin, a prescription medication used to treat severe forms of acne tends to increase the risk of developing nummular dermatitis in the future, and patients treated for hepatitis C with interferon can develop severe, generalized nummular dermatitis.
With proper treatment, nummular dermatitis can clear completely over time, although lesions on the legs typically take longer to heal and can leave permanent discolorations. There are several treatments available for nummular dermatitis. Topical corticosteroids and tar preparations are used to help control the irritation and inflammation. Antibiotics are used when a bacterial infection develops, and antihistamines can be used for patients who are having trouble sleeping due to the symptoms of nummular dermatitis. When a patient has developed severe, widespread lesions, treatment may require special dressings, phototherapy, oral antibiotics, systemic corticosteroids or bed rest in a cool, moist environment.
Once nummular dermatitis has been treated and the lesions clear, there are a few simple precautions that can be taken to prevent a recurrence. Apply moisturizer at least once a day, preferably directly after bathing while the skin is still damp. When showering or bathing, wash for no more than 5 minutes once a day, and use lukewarm water. Avoid using washcloths, sponges or brushes, and use only a mild, non-drying cleanser when bathing. When heating or air conditioning is necessary, using a humidifier to add moisture to the air helps prevent the skin from drying out. When getting dressed, try to choose loose fitting clothing, and avoid rough fabrics, such as wool, which can be irritating to the skin. When doing laundry, only use fragrance-free detergents, such as All, Cheer-Free, Era or Wisk Unscented, and do not use dryer sheets, fabric softener or bleach (liquid or dry). Try to limit your exposure to all fragranced products as they can be irritating to the skin.
