Discoid Eczema
Introduction
Discoid eczema (ek-suh-muh) or discoid dermatitis (duh-ma- tai-tuhs) is a common skin condition that causes coin shaped areas of red itchy skin. It is mainly seen on the arms and legs. It is also known as “nummular” dermatitis.
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A round red rash of discoid or nummular eczema on the leg of a child
Who gets it?
People of all ages can be affected by discoid eczema. Boys and men are more affected than girls and women. 1 in 500 people are affected. People who get other types of eczema, including genetic (atopic) eczema and contact eczema are more likely to also get discoid eczema.
What causes it?
The exact cause of discoid eczema is unknown, but many factors are known to play a role, such as:
Genetics: The condition can run in families, however there is no known gene that can be tested. Sometimes there is no family history, a child may be the only person in that family to have discoid eczema.
Infection/trauma: Sometimes discoid eczema develops after a child has an insect bite or trauma such as a burn.
Allergic conditions: People with asthma or hay fever are more likely to get this eczema.
Dry skin: People are more likely to get discoid eczema if they have dry skin, especially in colder months. Contact with products known to irritate the skin, such as soap or detergents can lead to dry, vulnerable skin and then worsen discoid eczema.
What does it look and feel like?
Looks like…
Each spot usually starts as a flat, coin shaped area of pink skin. Over time it can become thicker and develop a scale.
In some children, it can ooze and blister.
One child may have multiple round rashes in different locations on their body at the same time.
Discoid eczema can be mistaken for ringworm (fungal infection), however it will not clear up with fungal cream.
Feels like…
It is an extremely itchy condition.
Skin can become lumpy as it thickens in patches that last a long time.
What tests might be needed?
Generally no tests are needed for discoid eczema, however it is important for a GP or dermatologist to diagnose it. A doctor may perform a skin test on your child to rule out a fungal infection known as ringworm. If the skin is broken, a bacterial or viral infection may occur at the site of the discoid eczema. In that case, your child's doctor may do tests for viruses and bacteria, which will need treating in addition to the eczema.
What treatments are available?
What can I do?
If you find that dry skin leads to discoid eczema in your child, simple moisturisers and avoiding irritants such as soaps and detergents can assist in preventing flairs. Moisturisers should be applied twice a day, especially after showers/baths, as directed by your GP or dermatologist.
Wearing cotton clothes is better for the skin than synthetic materials.
There are no specific diets or foods that are known to improve or worsen discoid eczema. Maintaining a healthy diet and exercising are important for every child’s health.
Medical therapies
All medical therapies for discoid eczema should be prescribed by a doctor, usually a dermatologist.
Creams: Prescription and non-prescription creams can assist in controlling discoid eczema. These include thick moisturisers and steroid creams. Your child’s doctor will tell you about the options that are best for your child.
Tablets: In some cases, tablets can be used to help to treat discoid eczema. These include antibiotics or antiviral medication if an infection has been identified due to skin damage. Tablet or liquid steroids may be given for several weeks if your child has a severe form of discoid eczema. Antihistamines can also help reduce itch in children.
What happens after treatment?
Avoiding irritants, looking after your child’s skin with moisturisers and treating flares as directed by your doctor can lead to complete clearance of your child's discoid eczema. Some children may experience ongoing flares (chronic) that require medical therapies, whereas others may only experience it once or twice.
What support is available?
Your GP and dermatologist will work together to look after your child and improve their discoid eczema. The Eczema Association of Australia https://www.eczema.org.au/ is a useful website that may provide you and your family with support/information.
Authors/Reviewers:
Author: Dr Thomas Guy
Paediatric Reviewer: Dr Mayuri Sivagnanam
Editor in Chief: Dr Tevi Wain
