Tinea corporis may be diagnosed through potassium hydroxide examination of scrapings. Krogh HK. A review, follow-up and analysis of a series of 325 cases. The diagnosis can be made clinically based on the presentation of skin lesions with arthritic symptoms and colicky abdominal pain. Erythema multiforme. Asian Pac J Allergy Immunol 2013; 31(1): 36-42. Christova P. Concerning the correlation with age, nummular eczema is predominantly an adult affection; however, it is observable, albeit with low incidence, even in pediatric age [17Bonamonte D, Foti C, Vestita M, Ranieri LD, Angelini G. Nummular eczema and contact allergy: A retrospective study. Grant-Kels JM. Topical corticosteroids and oral antihistamines can be used to alleviate pruritus. Thyroid dysfunction and cutaneous sarcoidosis. Want to use this article elsewhere? The rash develops 30 minutes to eight hours after ingestion of the drug. 38. Nummular eczema with staphylococcal sensitivity. Allergy 2008; 63(7): 947-9. Hsu WT. Nummular eczema, also known as nummular dermatitis or discoid eczema, is a chronic condition that causes coin-shaped spots to develop on the skin… 157, Philadelphia, PA 19107 (e-mail: Ely JW, An annular lesion on the elbow. 2013;87(9):626–633. This study was carried out in accordance with the principles laid in CARE guideline. [PMID: 18402293] , 29Pugliarello S, Cozzi A, Gisondi P, Girolomoni G. Phenotypes of atopic dermatitis. The lesions are discrete and may be papular, vesicular or exudative (oozing). 4. Pediatr Rev. Nummular eczema presents as a rash composed of coin-shaped papulovesicular erythematous lesions. New cases of secondary syphilis must be reported to the Centers for Disease Control and Prevention.41. 2006;74(10):1729–1734. 1857; 238.] In non-atopic subjects, however, contact sensitization to occupational and / or non-occupational haptens is the “primary” cause of nummular lesions. Dermatitis 2012; 23(4): 153-7. Treatment options include topical or systemic corticosteroids, as well as UVA and UVB phototherapy.17. Lichen planus is a chronic, inflammatory, autoimmune condition that is classically described using the six P's: planar, purple, polygonal, pruritic, papules, and plaques (Figure 5). Sirot G. Nummular eczema. The classic lesions are annular and raised, and have central erythema described as target-like (Figure 4). Khurana S, Jain VK, Aggarwal K, Gupta S. Patch testing in discoid eczema. Barankin B. Krupa Shankar DS, Shrestha S. Relevance of patch testing in patients with nummular dermatitis. Krueger GG, Kahn G, Weston WL, Mandel MJ. 1857; 238. The Washington Manual of Dermatology Diagnostics. Cochrane Database Syst Rev. Skin hydration with emollients should be included in the basic therapy for nummular eczema. 2003;207(4):349–353. Discoid eczema day 6. Am Fam Physician. Wormser GP, Acta Derm Venereol 1961; 41: 453-60. Assessment of urticaria and angiooedema. It is more common in black patients 10 to 39 years of age. Gilliam BL. Martínez-Blanco J, García-González V, González-García J, Suárez-Castañón C. Nummular dermatitis: Report of two cases in children. Nummular eczema can affect the young as well as the old and both genders. Lichen planus. Dermatitis 2014; 25(4): 155-62. Sehgal VN, Camp Discovery changes that. Sternbach MR, Lichen planus characteristically appears as planar, purple, polygonal, pruritic papules and plaques. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category.". Eczema looks and acts differently in infants and toddlers than it does in older children. The diagnosis is made by rapid plasma reagin testing confirmed by treponemal testing. 2004;18(1):111–112. et al. Topical corticosteroids are sufficient for treatment of mild disease (covering less than 5% of the body surface). Bianchetti MG. ", "In principle, all scientific journals should have open access, as should be science itself. In subjects with atopic nummular eczema, contact allergy can be interpreted as a “complication” of the pre-existing dermatitis, a consequence of the repeated topical application of drugs and cosmetics. Lindsay TJ. [http://dx.doi.org/10.1097/DER.0b013e318260d5a0] [PMID: 228282 53] ]. Wolfrey J. KATHRYN P. TRAYES, MD, is an assistant professor in the Department of Family and Community Medicine at Thomas Jefferson University Hospital, Philadelphia, Pa.... KATHERINE SAVAGE, MD, is a resident in the Department of Family Medicine at Drexel University College of Medicine, Philadelphia. The lesions of plaque psoriasis are pruritic, sharply demarcated, erythematous, and round or ovoid, with silver plaques that bleed easily with trauma 10 (Auspitz sign; Figure 3). Between non-atopic and atopic nummular eczema there are several significant differences. It usually involves itchy, dry skin or a rash on swollen, reddened skin. Nummular eczema, therefore, is an important pattern of presentation of atopic dermatitis, regardless of its association to high serum total IgE levels, the presence of specific IgE and the personal or family history of atopy [30Lange L, Rietschel E, Hunzelmann N, Hartmann K. Elevated levels of tryptase in children with nummular eczema. Annular lesions occur less commonly in persons with fixed drug eruptions, leprosy, immunoglobulin A vasculitis, secondary syphilis, sarcoidosis, subacute cutaneous lupus erythematosus, and granuloma annulare. Diagnosis and management of Lyme disease. Cyr PR. WHO expert committee on leprosy: eighth report. The location and appearance of eczema changes as they grow, so it’s important to know what to look for during every stage of your infant or toddler’s life. Luba KM, Data Sources: A PubMed search was completed in Clinical Queries using the terms annular lesions, tinea corporis, Lyme, plaque psoriasis, erythema multiforme, lichen planus, nummular eczema, pityriasis rosea, herpes simplex virus type 1, and urticaria. Henoch-Schönlein purpura. Bluman J, Early prednisone therapy in Henoch-Schönlein purpura: a randomized, double-blind, placebo-controlled trial. Tinea corporis. Weigle N, IgE levels in nummular eczema and ichthyosis. 2007;76(11):1709–1710. 14. Centers for Disease Control and Prevention. July 27, 2016. 2014;60(11):1007–1010. Lamoreux MR, Swick BL. 18. Leung AK, Allergy 2008; 63(7): 947-9. Price HN. 2014;(8):CD009992. Wanat KA, Cutaneous lupus erythematosus: a review. Erythema multiforme is a skin condition that is thought to be a hypersensitivity reaction to infections or drugs. This clinical content conforms to AAFP criteria for continuing medical education (CME). Johnson RP. Willis NS, Fixed drug eruption (FDE): changing scenario of incriminating drugs. UVB phototherapy for pityriasis rosea: a bilateral comparison study. 2016;93(10):840–848. 2010; Vol. Nambiar AM. Children with eczema always have dry skin. Erythema annulare centrifugum. AMA Arch Derm Syphilol 1953; 68(1): 69-79. reports an incidence of 7% on all forms of eczema. Tizard J. Dattwyler RJ, Dudley J, 23. Nummular eczema presents as a rash with coin-shaped, scaly, pruritic, erythematous lesions (Figure 6). et al. Within two weeks, diffuse cutaneous involvement occurs with the eruption of multiple, round or ovoid, collarette lesions with scaly borders.2 The rash most commonly presents on the trunk and follows skin folds in a “Christmas tree” distribution.21 An influenza-like prodrome precedes the rash in 5% of patients.22 Workup should include a rapid plasma reagin test to exclude syphilis, especially if the rash is present on the palms and soles in sexually active patients. Wolter S, Systemic lupus erythematosus: primary care approach to diagnosis and management. Discoid eczema, also known as nummular or discoid dermatitis, is a long-term (chronic) skin condition that causes skin to become itchy, swollen and cracked in circular or oval patches. [PMID: 13754453] , 25Cowan MA. ", "These journals provide researchers with a platform for rapid, open access scientific communication. There is no cure for sarcoidosis; treatment is aimed at alleviating symptoms. Price HN. Mid- to high-potency topical corticosteroids are considered the mainstay treatment, but there are limited data on the use of systemic therapy for nummular eczema in children. Bieniek ML. Bluman J, Villiger RM, Granuloma annulare lesions usually resolve spontaneously within two years.49,50. "Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines. People … UVB phototherapy for pityriasis rosea. In particular, the incidence of contact allergy was studied in various cohorts of patients with nummular eczema [13Fregert S, Hjorth N, Magnusson B, et al. Ulcerative sarcoidosis. Many factors have an etiological role in subjects with nummular eczema. Menter A, Discoid eczema is also called nummular dermatitis. 2014;8(5):YC01–YC04. Ala-Houhala M, 3. Devergie MGA. J Am Acad Dermatol. Topical antifungal treatments for tinea cruris and tinea corporis. The disorder presents with round, eczematous patches or plaques that appear most often on the extremities and trunk. J Dermatol 2002; 29(12): 763-7. Biswas N, Le EH, Diagnosis, treatment, and prognosis of erythema migrans and Lyme arthritis. Urticaria. Talwani R, Dermatitis 2012; 23(4): 153-7. Abeles M, Seabury Stone M. Randomised, double-blind, placebo-controlled trial to determine whether steroids reduce the incidence and severity of nephropathy in Henoch-Schonlein purpura (HSP). Reprinted with permission from Hsu S, Le EH, Khoshevis MR. Indian J Dermatol Venereol Leprol. [PMID: 21054785] ], with a respective incidence of 9% and 12% [18Patrizi A, Ricci G, Neri I, et al. Nummular eczema. [PMID: 13133643] ], along with alcoholism [7Higgins EM, du Vivier AW. Differential diagnosis of annular lesions. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. Binyou W. Pityriasis rosea may first present as a herald patch: a single erythematous lesion with raised, scaly borders (Figure 7). Feder HM Jr, The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America [published correction appears in Clin Infect Dis. 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