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Dermatology/Eczema for first time in older person

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Question
Dear Dr Fisher,

I am a 66 year old female and have just been diagnosed 2 day's ago with Eczema for the first time in my life. I started itching about 8 months ago, but thought it was because of having very dry skin due to being Hypothyroid, for the past 19 months, and I am on 75mg Thyroxine.

At the moment, I have the burning rash on the inside of my arms and legs and I have been prescribed various creams by my Dr.

I would like to know if it is unusual to have Eczema at my time of life and can it make me feel unwell. Also, is it due to being Hypothyroid? What is the best way of keeping it under control?

Thank you for your help!

Answer
How often do you get your thyroid tested by blood work? It maybe that the medication you are on is not effective at controlling your thyroid disease.

Nummular eczema is a type of eczema that is also known as nummular dermatitis and discoid dermatitis. While nummular eczema affects both genders and can occur at any age, the most common demographic is men ages 55 to 65 years. According to the National Eczema Association, nummular eczema does not run in families and it is not associated with asthma. The National Institutes of Health considers nummular eczema an allergy-related disorder.
CHARACTERISTICS
An outbreak of nummular eczema may begin with one lesion, or it may begin with multiple lesions. Lesions are typically coin-shaped. The word nummular is derived from "nummus," the Latin word for coin. The legs are the most common site for nummular eczema. It also occurs on the arms, hands and torso. It can take weeks or months for patches to clear. Legions typically ooze and form a crust. Itching and burning sensations may accompany the outbreak.
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CONSIDERATIONS
Nummular eczema is sometimes mistaken for the fungal infection ringworm. The lesions have a similar appearance. A skin biopsy can confirm the nummular eczema diagnosis. Unlike ringworm, nummular eczema is not contagious, but it can lead to a secondary skin infection. Most eczema patients have staph bacteria on their skin. Broken skin often accompanies eczema, and this can allow bacteria to enter the body.
TREATMENTS
A dermatologist may recommend treatment with skin care products for mild cases of nummular eczema. Mild soaps and moisturizers with emollients are often recommended. For more severe cases, the dermatologist may prescribe corticosteroids or immunosuppressive drugs. Products that contain tars and extracts of crude coal tar are sometimes prescribed. Antibiotics may be prescribed if a bacterial infection is diagnosed. Some patients benefit from ultraviolet phototherapy. The dermatologist may recommend a combination of treatments.
CAUSES
The exact cause of nummular eczema is unknown. Various factors are suspected, and it may be a combination of factors that leads to nummular eczema. Since dry skin is associated with nummular eczema, this type of eczema is often worse in winter. Taking the prescription medication isotretinoin may increase the likelihood of developing nummular eczema. Like other types of eczema, stress does not cause nummular eczema but it can worsen the condition.
PREVENTION
According to the National Institutes of Health, nummular eczema cannot be prevented. However, the disease can be managed by avoiding its triggers. Common triggers include excessive bathing and contact with wool clothing. After bathing or washing, the skin should be patted dry--not rubbed. Rubbing can aggravate the skin. Contact with soaps, detergents and chemicals can contribute to an outbreak. Contact with any known allergens should be avoided. If contact allergies are suspected, allergy testing may be recommended.
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Michael S. Fisher, <B>Ph.D., M.D.</B>

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