Discoid Dermatitis / Nummular Eczema (Flare Up)

Diagnosis: Discoid Dermatitis / Nummular Eczema (Flare Up)

Worsened after client attempted to dry brush. Client nummular eczema was triggered when attemptng to shave after months of bedrest. Working on phase and daily flare up plans in Stages of Change Method. In discovery, journaling, tracking, and measuring phase

Clinical Presentation

Worsened after client attempted to dry brush. Client nummular eczema was triggered when attemptng to shave after months of bedrest. Working on phase and daily flare up plans in Stages of Change Method. In discovery, journaling, tracking, and measuring phase

Clinical History

Submitted by Marisa. Originally posted January 23, 2020.

Treatment

See case discussion.

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: discoid, dermatitis, nummular, eczema, flare, marisa