History:

Nummular eczema is a common form of endogenous eczema that occurs in both adults above thirties and children 5-15 years old especially those having AD. Clinically, it is characterized by pruritic oval or rounded coined-shaped (hence the name nummular or discoid eczema), dull-red plaques. The surface of the plaques is either wet (crusted or studded with pinpoint vesicles) or dry (covered with scales). The sites of predilection are the dorsal surface of the hands and the extensor aspects of the arms and legs. The course of discoid eczema is usually chronic with relapses & remissions. This 14-year-old girl has had recurrent attacks of nummular eczema on both upper and lower extremities especially the acral parts of 3 years duration. The previous episodes responded well to topical corticosteroids and systemic antihistamines. She presented with severely pruritic, multiple, crusted, erythematous plaques on the dorsal surface of both ands of two weeks duration.