Dear Dr. Gott: I am an 86-year-old male, and, approximately two years ago, I was diagnosed with nummular dermatitis. This disease causes spots of rashes that appear on all parts of my body after the areas get very itchy. I trust my diagnosis because my dermatologist is a professor of dermatology at the Yale University School of Medicine. He said there is no cure and very little research because very few people have this disease. I am currently taking triamcinolone acetonide, which I have to apply to all affected spots twice a day.
 

Do you know anything about this condition? Can you offer any suggestions?
 

Dear Reader: Nummular dermatitis (ND) is a form of eczema. It usually occurs on the arms and legs but can appear anywhere on the body. The rash generally starts as papules (raised areas of skin) that then turn into plaques (flattened patches, such as those associated with psoriasis). These areas are generally very itchy and are frequently accompanied by abnormal dryness.
 

There are two peak ages of occurrence. People between 60 and 70 are most commonly affected, with a predominance in men. The second group is individuals between the ages of 20 and 30. Those in this group tend to be female, and many also have atopic dermatitis (common eczema). This disorder is rare in children.
 

Treatment for generalized (over most of the body) ND can include bed rest, oral antibiotics or steroids and being in a cool (not cold) environment. Taking cool or lukewarm baths or showers once or twice daily followed immediately by applying moisturizer can be beneficial. The skin must be damp while the moisturizer is applied to seal the moisture in.

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