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Coin eczema: features, diagnosis, treatment

Eczema coin-shaped (numular) is characterized by the appearance of rounded generalized foci of inflammation in the form of rapidly boiling papules and vesicles. The sizes of the primary lesions vary from 1 to 5 cm. Externally, the rash is very similar to a fungal infection, accompanied by severe itching. The first manifestations of coin eczema are localized on the lower extremities, and over time they spread to other parts of the body (trunk, back of the palms), without any specific location.

Most often, coin eczema occurs in the adult population, and women are much less susceptible to it than men. The disease develops gradually, without sudden jumps and without a history of this disease.  

Eczema belongs to a group of chronic skin diseases, the etiology of which is not fully understood. It is believed that the main causes of the onset and development of the disease are hereditary factors, external stimuli (allergens of chemical or thermal origin), mechanical injuries of the skin, disturbances in the functioning of systems and organs of the body, deterioration of the functions of the immune system, etc.

Clinical presentation and diagnosis

Specific external symptoms of coin-shaped (nullary) eczema are round plaques with well-defined boundaries, with a scaly surface in the form of small crusts. The characteristic zones of the rash are the lower and upper limbs, sometimes the torso. The clinical picture of the acute form of the disease is determined by the pronounced weeping of the epidermis in the lesions and the formation of new vesicular rashes.

Coin eczema is often identified by acute lesions with exudate (secretion of serous fluid) and crusts, or chronic lesions with erythema and a scaly surface. In the acute form of the course, a secondary infection may join the eczematous lesion, which aggravates the course of the disease. The symptoms of such processes are thick honey-yellow crusts on the surface of the lesions.  

All stages of development of eczema are accompanied by itching of varying intensity (usually very strong, boring).

Since the external signs of coin eczema are similar to the symptoms of other skin diseases, when diagnosing, the doctor will certainly carry out the so-called differential diagnosis. Should be excluded:

– T-cell cutaneous lymphoma of the legs, which is often mistaken for coin eczema;

– psoriasis, the hallmarks of which in this case are the “geographical” contours of the lesions;

– fungal infections, the symptoms of which are scaly, well-defined edges of the lesions and a noticeable regression of rashes in the center.

Coin eczema can be treated with great difficulty, since the course of the disease is often unpredictable, changeable, with frequent relapses. The disease can remain in this state for an indefinite number of months or even years. It is also characteristic of this form of eczema that the lesions tend to retain their size even at the stage of remission and recur during periods of exacerbation in the same areas.  

How to treat?

When prescribing torpid treatment, it is imperative to conduct a patchwork test. The use of topical allergens, which include certain drugs (hydrocortisone, bacitracin, neosporin, etc.) can provoke the development of coin-like dermatitis. Therefore, it is necessary to abandon the use of all unnecessary moisturizing external agents, OTC medications for internal use, infusions and decoctions of medicinal herbs.

If you have mycosis or fungal infections, antifungal drugs are prescribed. The presence of secondary infection in the lesions requires treatment with anti-staphylococcal antibiotics of systemic action. To reduce itching, antihistamines must be prescribed. Good results of symptomatic treatment of mono-eczema are shown by phototherapy – irradiation of the affected areas of the skin with ultraviolet radiation of the B spectrum.

In any case, treatment should be carried out only under the supervision of a specialist. Self-medication and treatment of eczema with folk remedies is highly discouraged.

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