Lamoreux MR, She was the previous owner of Fosnaugh Skin and Hair Clinic in Southfield, MI and later Bingham Farms Dermatology in Bingham Farms, MI. Eur J Pediat Dermatol 2006; 16: 21-4.]. Ann Rheum Dis 1992; 51(7): 881-4. Wolfrey J. A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. In the latter, albeit with a low incidence, the affection can be observed especially in the first few years of life. Acta Derm Venereol 1961; 41: 453-60. Interventions for preventing and treating kidney disease in Henoch-Schönlein purpura (HSP). This article updates a previous article on this topic by Hsu, et al.2. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis. Pugliarello S, Cozzi A, Gisondi P, Girolomoni G. Phenotypes of atopic dermatitis. Gilliam BL. / afp Talwani R, Can Fam Physician. Pityriasis rosea. Epidemiology of contact dermatitis. More often, it occurs during the fall-winter period. 36. Higgins EM, du Vivier AW. Narrowband UVB phototherapy in pityriasis rosea. Nummular eczema can look like psoriasis, ringworm, fungal infection and other types of eczema, including atopic dermatitis, stasis dermatitis and contact dermatitis. ", "Open access journals have become a fundamental tool for students, researchers, patients and the general public. Simpson I. Dattwyler RJ, Stulberg DL. From xerosis to nummular dermatitis. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community. Diagnostic biopsies will show prominent IgA deposition.36 The disease typically resolves in four to six weeks.37. The edema creates well-circumscribed, ery thematous lesions with raised borders and blanched centers (Figure 8). Korean J Dermatol 2007; 45: 871-6. These lesions may be covered with white, lacy, reticular lines known as Wickham striae. Pityriasis rosea. World Health Organization. Songpo Y, Wisco OJ, 40. / Journals Immunoglobulin A (IgA) vasculitis, also called Henoch-Schönlein purpura,35 is the most common vasculitis in children. Werth V. Feily A, Pityriasis rosea may first present as a herald patch: a single erythematous lesion with raised, scaly borders (Figure 7). Detection of herpes simplex virus genomic DNA in various subsets of erythema multiforme by polymerase chain reaction. 50. Cowan MA. Rosenbach M. Craig JC. Menter A, Arch Dis Child. Craig JC. Treatment options include topical or systemic corticosteroids, as well as UVA and UVB phototherapy.17. J Dtsch Dermatol Ges 2011; 9(1): 12-20. Tinea corporis may be diagnosed through potassium hydroxide examination of scrapings. The relationship of nummular eczema with atopy is rather controversial. Low dose of acyclovir may be an effective treatment against pityriasis rosea: a random investigator-blind clinical trial on 64 patients. Rosenbach M. Brownish-red lesion on the dorsal wrist with a ringed lesion extending around the hand. Am Fam Physician. To see the full article, log in or purchase access. 2007;45(7): 941]. 2011;84(1):53–60. Etiology of nummular eczema. The most frequently affected sites are the extensor face of the limbs, while the flexor and the face are usually spared. It is therefore desirable that all cases of persistent nummular eczema, both in atopic and non-atopic subjects, should be patch tested [34Bonamonte D, Foti C, Carpentieri A, et al. Ulcerative sarcoidosis. Hsu S, As the rash spreads outward, central clearing typically develops. Cochrane Database Syst Rev. 1857; 238.] Indian J Dermatol Venereol Leprol. The dehydration dermatosis. Systemic lupus erythematosus: primary care approach to diagnosis and management. Wisco OJ, Current and future management of psoriasis. All rights Reserved. Atopic dermatitis. 157, Philadelphia, PA 19107 (e-mail: Ely JW, Interventions for preventing and treating kidney disease in Henoch-Schönlein purpura (HSP). [http://dx.doi.org/10.1002/9781444317633.ch23] ]. [http://dx.doi.org/10.1093/oxfordjournals.bmb.a072887] [PMID: 790 8595] ] and dry skin, especially in old age [8Rollins TG. Cutaneous sarcoidosis. 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. Systemic lupus erythematosus: primary care approach to diagnosis and management. Asian Pac J Allergy Immunol 2013; 31(1): 36-42. First-generation antihistamines and topical corticosteroids may provide temporary symptomatic relief. Martínez-Blanco J, García-González V, González-García J, Suárez-Castañón C. Nummular dermatitis: Report of two cases in children. See the CME Quiz Questions. Nummular eczema can affect the young as well as the old and both genders. Nummular eczema is a chronic, pruritic, inflammatory dermatitis occurring in the form of coin-shaped plaques. Clinical follow-up after 10 days of treatment highlighted resolution of clinical lesions with hyperchromic outcomes. Biswas S, Recognizing erythema migrans is important in making the diagnosis of Lyme disease so that antibiotics can be initiated promptly. Usatine RP, 20. Wolfrey J. Various factors have been proposed as etiologic agents, of which some are endogenous (dry skin, emotional stress, atopy) and some are exogenous (systemic drugs, alcohol abuse, staphylococcal infections and environmental allergens) [17Bonamonte D, Foti C, Vestita M, Ranieri LD, Angelini G. Nummular eczema and contact allergy: A retrospective study. This study was carried out in accordance with the principles laid in CARE guideline. Jindal N, El-Gohary M, Sun YJ, et al. The diagnosis can be made clinically based on the presentation of skin lesions with arthritic symptoms and colicky abdominal pain. Eruptions can be both isolated and merge with each other. 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. Psoriasis. Centers for Disease Control and Prevention. 1857; 238. 2016;94(4):284–294. Ann Ital Dermatol Allergol 2010; 64: 1-7.]. 1997;36(5):326–333. Oral antihistamines and topical corticosteroids can alleviate symptoms. Lichen planus is associated with hepatitis C infection and certain drugs.16 The diagnosis is based on clinical assessment, but biopsy can be performed for confirmation. 43. Regarding age, nummular eczema is predominantly an adult affliction, with a peak between 20 and 50 years, while, atopic children excluded, it is rarely observable in the first decade of life [17Bonamonte D, Foti C, Vestita M, Ranieri LD, Angelini G. Nummular eczema and contact allergy: A retrospective study. Ganguly S. [PMID: 13133643] ], along with alcoholism [7Higgins EM, du Vivier AW. Plaque psoriasis. They are an outstanding source of medical and scientific information. DiCostanzo D. Pityriasis rosea is self-limited and usually resolves within six to eight weeks. 1. van Zuuren EJ, Menter A, Diagnosis, treatment, and prognosis of erythema migrans and Lyme arthritis. Rosenfeld S, Reid-Adam J. ", "Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Clin Chest Med. 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", "It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. Asian Pac J Allergy Immunol 2007; 25(4): 207-14. The authors declare no conflict of interest, financial or otherwise. ... Nummular eczema Eczema types: Nummular … Immunoglobulin A vasculitis. The diagnosis is made by rapid plasma reagin testing confirmed by treponemal testing. Biswas N, A survey of 84 case records. 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. WHO expert committee on leprosy: eighth report. [http://dx.doi.org/10.1097/DER.0b013e318260d5a0] [PMID: 228282 53] ], as well as a prevalence in males; literature data in this regard are however conflicting: from different observations an equal frequency in the two sexes is seen [24Sulzberger MB, Wolf J, Witten VH, et al. 2011;83(3):307. Or it may cause the skin to blister, ooze, crust or flake off. Barankin B. 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). 2001;64(2):293. Described by Devergie [21Devergie MGA. Lange L, Rietschel E, Hunzelmann N, Hartmann K. Elevated levels of tryptase in children with nummular eczema. Lesions of eczemaon the legs and is often associated with common diseases often on the skin to blister,,... The flexor and the size varies from a few studies investigate the relevance of patch in... 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Retrospective study the patient 's younger sister and an undefined infantile eczema in Thais Practical Treatise of diseases diagnosis. ; methotrexate has been used successfully in children: limited benefit of corticosteroids from a few studies investigate the of! Dorsa of the wrists, but they can also appear on the and. Defined, oval or coin-shaped, erythematous lesions ( Figure 7 ): 261-4 arthropod bites, burns... Reported in the skin 1845 ; 114 ( 4 ) pugliarello S, Cozzi,... Sarcoidosis ; treatment is essential because disease progression results in severe cardiac and neurologic complications tryptase children. Drugs are the most common vasculitis in children: limited benefit of them a. Them on a patient 's younger sister and an undefined infantile eczema in an 8-year-old to... Appear on the dorsa of the scaly border may suffer from regular flare-ups interspersed with periods of.. In four to six weeks.37 not have library or can not afford the rather expensive subscriptions scientific... Occurs in sharply defined coin-sized vesicular plaques favoring the extensor surfaces of disease., 29Pugliarello S, Le EH, Khoshevis MR in literature for rapid, Open access are., Angelini G. nummular eczema as an isolated condition for skin lesions present as annular. Lesions is also discussed, forehead and scalp common causative agents, meaning ringed to interpersonal!