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Monday, September 22, 2014
Skin Care and Diseases
MY HUSBAND NEEDS HELP WITH NUMERLAR DERMATITIS OR ECZEMA. ITS IN FULL SWING FROM HEAD TO TOE, ESPECIALLY THE HANDS. ITS SPREADING EVERYDAY. HE HAS SEEN A SPECIALIST BUT THE CREAMS ARE NOT HELPING. HOW DO WE CONTROL AND STOP THE ITCHING. PLEASE HELP
Nummular eczema is often a chronic itching condition of unknown cause that goes through periodic flares and improvements.
When localized or mild, it can be treated with topical or injectable steroids, topical immunomodulators (such as topical pimecrolimus cream or tacrolimus ointment), excimer laser (a localized light therapy that may not be covered by insurance), or a combination of these. When the condition is more generalized, actively spreading, severely itching, or in other ways affecting the quality of life of the patient therapies include oral or intramuscular corticosteroids, phototherapy (special medical light therapy, like a tanning bed but different wavelengths of ultraviolet light), methotrexate, cyclosporine, or other immunosuppressive therapies. The choice of treatment is dependent upon other medical conditions, logistical issues, insurance coverage, severity of the condition, and the comfort level of the physician prescribing the treatment.
I would recommend seeing your board certified dermatologist again if it is worsening and ask if any of these are an option for your husband. If your dermatologist is not comfortable with these therapies, and the condition is worsening, a referral to a University based dermatologist may be needed.
Pranav Sheth, MD
College of Medicine
University of Cincinnati