Discoid eczema is usually associated with dry itchy skin, together with a tendency to uncontrolled scratching because of a stressed temperament. Sometimes it is referred to as neurotic eczema.

Signs

It can affect all age groups, but usually in middle-aged or older people. It happens in areas, which are easy to be reached and scratched, such as the limbs, and back of the neck.

It appears as discrete, coin-shaped, well-defined patches of eczema. Usually the pattern on the limbs is symmetrical. The lesions are felt as very itchy, so thickening of the skin (lichenification) is common after prolonged scratching.

Because of their well-defined margins, lesions of discoid eczema can be confused for fungal infections of the skin or for contact eczema.

Management & Treatments

Treatments are essentially the same as for other types of eczema. It is a must to try to control scratching, which is the main culprit and make the problem recur. Lots of moisturisers should be applied which will keep the affected area thin and not so itchy.

Because the skin is usually thickened, more potent steroid cream would be needed, often mixed with salicylic acid to promote the penetration into the skin. The newer anti-inflammatory creams should also be effective, and reduce the need for steroids. If necessary the area can be occluded with cling film, which will further enhance the penetration and absorption, with the problem resolving within weeks.

Infection is common in discoid eczema, topical or oral antibiotic treatment may be required.