Discoid Dermatitis / Nummular Eczema - Flare Up During Menses

Diagnosis: Nummular Eczema (Discoid Dermatitis)

Nummular eczema case showing flare-up patterns during menses, triggered by shaving after prolonged bedrest.

Clinical Presentation

Client presented with recurrent flare-ups of nummular eczema. Worsened after attempting to dry brush. Flare-ups correlate with menstrual cycle.

Clinical History

Client nummular eczema was triggered when attempting to shave after months of bedrest. Working on phase and daily flare-up plans using the Stages of Change Method. Currently in discovery, journaling, tracking, and measuring phase.

Treatment

Stages of Change Method approach with daily flare-up management plans. Focus on identifying triggers and tracking patterns.

Differential Diagnosis

• Psoriasis • Contact dermatitis • Scabies • Tinea corporis • Seborrheic dermatitis • Mycosis fungoides • Drug eruption

Key Learnings

• "Eczema" is a clinical pattern, not a single diagnosis — encompasses multiple subtypes • Impaired skin barrier function is central to pathogenesis • Spongiosis (intercellular edema in epidermis) is the histological hallmark • Acute: vesicles, weeping. Subacute: erythema, scale. Chronic: lichenification, fissuring • Superinfection with S. aureus is common and may cause flares

Tags: nummular eczema, discoid dermatitis, eczema, flare up, hormonal triggers, dermatitis