What treatment is indicated for generalized and prolonged eruptions in nummular dermatitis?

Updated: Nov 21, 2019
  • Author: Jami L Miller, MD; Chief Editor: William D James, MD  more...
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Answer

When eruptions are generalized and prolonged, more aggressive therapy is warranted. Phototherapy (generally with ultraviolet [UV] B) may be helpful. [33] Broadband or narrowband UVB is most commonly used, although psoralen plus UVA (PUVA) may be used in severe cases. Oral immunosuppressive agents may help to attenuate the immune response; methotrexate has been used successfully in children with nummular eczema. [34] Data are lacking for other immunosuppressants such as azathioprine and mycophenolate mofetil in the treatment of nummular eczema, although these medications have been used in other forms if dermatitis. Dupilumab, a monoclonal antibody targeting interleukins 4 and 12, has also been used successfully in atopic and other forms of dermatitis, but thus far there are not any reports of its use in nummular eczema. Mindfulness-based therapies, including meditation and hypnotherapy, have also been reported to be helpful. [35]


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