Clinical Study on Nummula Eczema

Choe, Yoon Seok; Lee, Seok Jong; Na, Gun Yoen; Kim, Do Won

Abstract

BACKGROUND
Nummular eczema, known as nummular dermatitis or discoid eczema, is an idiopathic disease that manifests coin-shaped, circular, or oval-shaped plaques with definite margins. These plaques can be exudative, erythematous, or edematous. The plaques are composed of tiny vesicles in the early stage, and later tend to be more scaly, dry, lichenified and thickened. It is a chronic condition which exhibits long periods of recurrence and relapse, plus changes depending on environmental conditions. For example, it is known that the eczema worsens in low humidity, or during winter. OBJECTIVE: Since there has been an absence of studies conducted since the 1970's, we investigated epidemiology, etiology, aggravation factors, family and past history, associated diseases such as atopic dermatitis, clinical menifestations, laboratory abnormalities, and course and prognosis with statistical analysis. METHOD: A total of 211 individuals, who had visited the Department of Dermatology, Kyungpook National University Hospital in Daegu, Korea between 2000-2004 with a diagnosis of nummular eczema, were selected. The data was based on a retrospective survey of hospital records. However, whenever the information was lacking, we called patients to ask lists of questions for this investigation. To clarify the prognosis and course of nummular dermatitis, we classified the course of the disease into 5 groups; "healed" (cleared completely), "almost healed" (more than 90% cleared), "improved" (from 50 to 90% cleared), "stationary" (less than 50% improvement), and "wax & waned" (repetitive recurrence). RESULTS: The male to female distribution showed about a 1.4-fold predominance for males. The onset of the disease in patients was often in their twenties, which correlated with previous reports which noted that onset of lesions in patients occurred in their twenties and sixties. Nummular eczema was most frequently aggravated in summer. Thirty five of the 211 patients had atopic dermatitis, and 53 had dry skin. Thirty five of 103 patients showed an elevated serum Ig E level (more than 250 IU/ml). Seventeen of 120 patients had an elevated eosiophil count (more than 7%). If the patients had had the eczema for a short duration, these seemed to be a better chance of the condition healing. CONCLUSION: This investigation is expected to help understand and obtain more information on nummular eczema.