Nummulair Eczeem of Psoriasis - Wat is het Verschil?

Zo zie je het verschil tussen psoriasis en eczeem

Natuurlijk zijn eczeem en psoriasis niet hetzelfde, maar toch kunnen ze op eerste oogopslag nogal op elkaar lijken. Het is echter belangrijk om te weten wat je huid écht plaagt zodat je de huidaandoening op jouw gezicht en/of lichaam ook doeltreffend kunt aanpakken. Nu, het zijn beide chronische huidproblemen die van tijd tot tijd kunnen opvlammen en verergeren. De kenmerken ervan kunnen verwarrend zijn, want zowel eczeem als psoriasis veroorzaken rode, schilferige plekken op de huid. Voor het ongetrainde oog is het lastig ze uit elkaar te houden. Lees hier hoe je erachter komt met welke huidaandoening, psoriasis of eczeem, jij daadwerkelijk te maken hebt. Laat een dermatoloog dit vervolgens liefst ook bevestigen. Zo kun je jouw uitslag zo goed mogelijk behandelen.

Prognosis

Nummular dermatitis often follows a chronic course characterized by relapses and remissions over months to years.

Because of the impaired skin barrier, lesional skin may become secondarily infected, staphylococcus aureus is the most commonly implicated pathogen. Impetiginized lesions can display purulent ooze and thicker golden crusting than noninfected lesions. A bacterial swab should be performed for culture and sensitivities. Based on local antimicrobial resistance patterns, doxycycline or another antistaphylococcal antibiotic may be selected initially, further treatment can be tailored according to the resultant sensitivities. As with any inflammatory condition of the skin, there may be postinflammatory dyspigmentation of the skin, including erythema, hypo-, or hyperpigmentation.

Overview - Discoid eczema

Without treatment, discoid eczema can last for weeks, months or even years. It may also keep coming back – often in the same area that was affected previously.

Discoid eczema causes distinctive circular or oval patches of eczema. It can affect any part of the body, although it does not usually affect the face or scalp.

The first sign of discoid eczema is usually a group of small spots or bumps on the skin. These then quickly join up to form larger patches that can range from a few millimetres to several centimetres in size.

On lighter skin these patches will be pink or red. On darker skin these patches can be a dark brown or they can be paler than the skin around them.

Initially, these patches are often swollen, blistered (covered with small fluid-filled pockets) and ooze fluid. They also tend to be very itchy, particularly at night.

Over time, the patches may become dry, crusty, cracked and flaky. The centre of the patch also sometimes clears, leaving a ring of discoloured skin that can be mistaken for ringworm.

You may just have 1 patch of discoid eczema, but most people get several patches. The skin between the patches is often dry.

Patches of discoid eczema can sometimes become infected. Signs of an infection can include:

• the patches oozing a lot of fluid
• a yellow crust developing over the patches
• the skin around the patches becoming hot, swollen and tender or painful
• feeling sick
• feeling hot or shivery
• feeling unwell

Causes of discoid eczema

The cause of discoid eczema is unknown, although it may happen as a result of having particularly dry skin.

Some people with discoid eczema also have a history of atopic eczema, which often happens in people who are prone to asthma and hay fever. However, unlike atopic eczema, discoid eczema does not seem to run in families.

Other possible triggers

An outbreak of discoid eczema may sometimes be triggered by a minor skin injury, such as an insect bite or a burn.

Some medicines have been linked to discoid eczema. You should not stop taking any prescribed medicine without talking to the doctor who prescribed it for you.

Dry environments and cold climates can make discoid eczema worse, and sunny or damp (humid) environments may make your symptoms better.

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.

Treating discoid eczema

Discoid eczema is usually a long-term problem, but medicines are available to help relieve the symptoms and keep the condition under control.

• emollients – moisturisers applied to the skin to stop it becoming dry
• topical corticosteroids – ointments and creams containing a steroid that are applied to the skin and may relieve severe symptoms
• antihistamines – medicines that can reduce itching

There are also things you can do yourself to help, such as avoiding all the irritating chemicals in soaps, detergents, bubble baths and shower gels.

Additional medicine can be prescribed if your eczema is infected or particularly severe.

Occasionally, areas of skin affected by discoid eczema can be left permanently discoloured after the condition has cleared up.