Discoid eczema- When being ‘rich’ is not wanted….
‘Dr, my daughters’ legs are full of coins!’ That was the presenting complaint of a concerned dad today. He elaborated that the lesions looks like multiple 5 cents and 10 cents coins.
What is discoid eczema?
Discoid means ‘disc’ shaped. Anything that is rounded and looks like a coin lesions can be described as being discoid. On the other hand, eczema means inflammatory skin disorder. Hence, discoid eczema literally means inflammatory skin disorder that is ‘disc’ shaped.
Discoid eczema is a very common skin disorder in the community. It occurs at any age without any gender disparity. The typical discoid eczema occurs over the lower limb. They are rounded, red, scaly and itchy. Due to the intense itch, patient tend to scratch it and results in weepy wounds that are easily infected. When it is weepy and infected, it is termed as the ‘wet discoid eczema’.
What causes discoid eczema?
Most of the time, there is no identifiable cause for this type of eczema. In children, it can be a manifestation of skin allergy (atopic dermatitis). Some people developed discoid eczema after a bout of insect bite reaction. For others, it can be a manifestation of skin contact allergy elsewhere i.e. nickel allergy and etc. Interestingly, it had been found to be more prevalent among people who abuses alcohol. Hence, it is important to find out any underlying cause of discoid eczema before starting treatment to enable correct treatment to target on the cause of the problem.
Why is discoid eczema of such concern?
Firstly, discoid eczema is one of the few eczema that causes intense itch and discomfort. Due to this nature of it, it is more prone for skin wound and infection. On top of this, it is more difficult to treat compared to most other eczema. Often, potent steroid creams are needed to be effective. Sometimes, underlying contact skin allergy is being overlooked and not treated, resulting in ineffective treatment of the condition. It is also often misdiagnosed and treated as fungal infection.
How to treat discoid eczema?
Firstly, we need to stop the itch to prevent scratches and further injury as well as infection by using antihistamines. Try to stop yourself from scratching. Keep your nails short and avoid irritants such as detergent, solvents, chemicals and etc.
On dry lesions, moisturisers are needed to moisture the lesion. This reduces the itch and scaling.
Potent topical steroids are used to reduce the skin inflammation. Examples are betamethasone dipropionate creams as well as betamethasone valerate creams.
When it is infected, antibiotic creams are needed to cure the infection. When severe, antibiotic tablets or syrup may be needed.
On rare occasions, steroid tablets or syrups and light therapy may be needed to relieve the lesion.
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