Alles wat je moet weten over Nummulair Eczeem volgens NHG-richtlijnen

How do you know if you have ringworm?

Ringworm often creates a ring-shaped rash with a raised, scaly border that snakes its way around the edge like a worm. Some experts believe that the appearance may be where it got its name.

Nummular eczema and ringworm are skin conditions that can cause round patches of itchy skin that vary in color depending on the tone of a person’s skin.

However, these conditions have different causes and treatments, so it is important to be able to differentiate between them.

Ringworm is a fungal infection that can spread between people. It is usually treatable with antifungal medications and should clear up within a couple of weeks.

Nummular eczema is an inflammatory skin condition. There is currently no cure for nummular eczema, but keeping the skin hydrated, avoiding known triggers, and using eczema medications can relieve symptoms and help prevent future flare-ups.

What Causes Nummular Eczema?

Eczema is characterized by the immune system's overreaction to substances or stimuli that result in an inflammatory skin reaction.

Eczema is also known as atopic dermatitis because it involves atopy , meaning a genetic tendency to develop allergic diseases such as allergic rhinitis (hay fever), asthma, and eczema.

With that said, scientists have only begun to identify the gene mutations associated with the disease. What they do know is that certain triggers—such as allergies, irritants, environmental changes, and even emotions—can instigate or aggravate symptoms.

The triggers most commonly associated with nummular eczema include:

Nummular eczema is more common in males than females. Males tend to develop symptoms between the ages of 55 and 65, while females generally develop them between the ages of 15 and 25.

Children rarely get nummular eczema and, when they do, it tends to be very severe.

What does nummular eczema look and feel like?

People with lighter skin usually develop red or brown areas on their skin. People with darker skin can develop dark brown patches, or they may develop patches that are lighter than their surrounding skin.

The rash appears as a round, coin-shaped, or oval patch in both cases. “Nummular” comes from the Latin term for “coin.”

These spots or patches can appear on the arms, hands, legs, or torso. They may be present in clusters or join up to form larger patches. As a result, they can range in size from a fraction of an inch to about 4 inches .

Other symptoms of nummular eczema may include:

• dry skin
• burning and itching of the skin, which is often worse at night
• open spots that may crust over

With treatment, the spots can heal and rarely scar over. On lighter skin, they may leave temporary areas of pale skin. On darker skin, the lesions can leave areas of hyperpigmentation or darker patches.

If the affected skin is open, it can become vulnerable to a bacterial infection. Infected nummular eczema may cause:

• redness
• swelling
• foul-smelling discharge
• fever

How Is Nummular Eczema Treated?

There is no cure for nummular eczema, but there are several ways to effectively manage the condition.

Skincare

Skin dryness is one of the major factors that contribute to exacerbations. Keeping the skin well moisturized strengthens the barrier protection and reduces the risk of flare-ups.

Here are some tips that can help:

• Apply moisturizer every day year-round. Apply to damp skin after every bath or shower, and every time you wash your hands. You should also do so whenever your skin feels dry.
• Use a fragrance-free, hypoallergenic cream or ointment, Avoid thick lotions that can block evaporation and trigger sweating.
• Shower or bathe for no longer than 20 minutes. Anything longer can oversaturate the skin and actually pull moisture out of the skin, leading to dryness.
• Use lukewarm rather than hot water for bathing or showering. Overheating the skin can also lead to moisture loss and skin dryness.
• Use mild, fragrance-free, and hypoallergenic skin care products. This includes soaps, cleansers, and wipes. Avoid overusing alcohol-based sanitizers that dry skin.
• Use a humidifier to increase air moisture. Both air conditioners and heaters can pull moisture out of the air and cause skin dryness.
• Prepare for extreme temperatures. Keep indoors as much as possible during summer heatwaves or hard freezes in winter. If you can't, try wearing moisture-wicking fabrics when in hot temperatures and light thermal underwear when in extreme cold.

Steroid Medications

Topical corticosteroids (steroids) are the first-line drug treatment for nummular eczema. Most cases respond well to intermediate- to high-potency steroids, often bringing flare-ups under control within one to four weeks.

Topical steroids are generally applied to affected skin two to four times daily. Ointments are often preferred over gels as they have emollients that help moisturize the skin.

Emollients

Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. They are often used to help manage dry or scaly skin conditions such as eczema.

Choice of emollient

Several different emollients are available. You may need to try a few to find one that works for you. You may also be advised to use a mix of emollients, such as:

• an ointment for very dry skin
• a cream or lotion for less dry skin
• an emollient to use instead of soap
• an emollient to add to bath water or use in the shower
• one emollient to use on your face and hands, and a different one to use on your body

The difference between lotions, creams and ointments is the amount of oil they contain. Ointments contain the most oil so they can be quite greasy, but are the most effective at keeping moisture in the skin. Lotions contain the least amount of oil so are not greasy, but can be less effective. Creams are somewhere in between.

Creams and lotions tend to be more suitable for red, inflamed (swollen) areas of skin. Ointments are more suitable for areas of dry skin that are not inflamed.

If you have been using a particular emollient for some time, it may eventually become less effective or may start to irritate your skin. If this is the case, your GP will be able to prescribe another product.

How to use emollients

Use your emollient all the time, even if you are not experiencing symptoms as they can help limit the return of your condition. Many people find it helpful to keep separate supplies of emollients at work or school.

To apply the emollient:

If you are exposed to irritants at work, make sure you apply emollients regularly during and after work.

Don’t share emollients with other people.

Side effects

Occasionally, some emollients can irritate the skin. If you have discoid eczema, your skin will be sensitive and can react to certain ingredients in over-the-counter emollients. If your skin reacts to the emollient, stop using it and speak to your GP, who can recommend an alternative product.