International Journal of Health Sciences & Research (www.ijhsr.org) 107 Vol.7; Issue: 3; March 2017 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Clinical Profile of Nummular Eczema in a Hilly Population and Associated Xerosis Renu Rattan 1 , Meena Chauhan 2 , Anuj Sharma 3 , Abhishek Sharma 4 , Gita Ram Tegta 5 1 Consultant Dermatologist, Deen Dayal Upadhyay Hospital, Shimla, Himachal Pradesh 2 Consultant Dermatologist, Civil Hospital Rohru, Himachal Pradesh, 3 Consultant Dermatologist, Regional Hospital Bilaspur, Himachal Pradesh, 4 Senior resident, Deptt of Dermatology, SLBS Medical College, Ner Chowk, Mandi, Himachal Pradesh, 5 Professor, Deptt of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, Corresponding Author: Renu Rattan Received: 27/01/2017 Revised: 16/02/2017 Accepted: 22/02/2017 ABSTRACT Background: Nummular eczema, a variant of endogenous eczema, is a common dermatoses with a chronic relapsing course. It is often associated with xerosis and impaired skin barrier. This study aimed at evaluating clinical profile of nummular eczema in a hilly population where xerosis of skin is a feature due to dry weather conditions. Methods: Forty consecutive patients of nummular eczema attending the out- patient department of a tertiary care centre were recruited in the study and their clinical details along with seasonal variation in the course of dermatitis were analysed. Results: There were 27(67.5%) males and 13(32.5%) females with a mean age of 39.1 ± 19 years. Most commonly involved site was lower limbs (in 72.5% patients), followed by upper limbs (in 50% patients), further followed by trunk (in 45% patients). Winter exacerbation of the dermatitis was seen in 57.5% patients, while 17.5% patients showed summer exacerbation and 25% of patients reported no seasonal variation. No history of atopy was seen in maximum number of patients i.e. 57. 5%. Conclusion: Nummular eczema follows a more chronic and relapsing course in the setting of dry skin conditions. Dry environmental conditions precipitate acute exacerbations of dermatitis. Key words: Nummular eczema, xerosis, dermatitis. INTRODUCTION Nummular eczema is a common type of endogenous eczema first described by Rayer in 1845 with a worldwide prevalence of 0.1% to 9.1%. [1] It is characterized by coin shaped or oval plaques with a clearly defined border. These lesions are itchy and often overlap with other clinical types of eczema but have no specific histopathological features. [2] The diagnostic lesion is a coin shaped plaque of closely set, thin walled vesicles on an erythematous base. In the acute phase, the lesions are dull red, oozy, crusted and highly irritable. They progress towards a less vesicular and more scaly stage, often with central clearing and peripheral extension causing ring shaped or annular lesions. It is very characteristic of this disease that the patches which have become apparently dormant may become active again. Little is known about pathophysiology of nummular eczema, but it is frequently accompanied by xerosis. This study aimed at assessing clinical findings and aggravating factors of nummular dermatitis and to evaluate characteristic pattern of disease in