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Dr. Peter Gott - Rare form of dermatitis has man baffled

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DEAR DR. GOTT: I am an 86-year-old male, and, approximately two years ago, I was diagnosed with nummular dermatitis. This disease causes spots of rashes that appear on all parts of my body after the areas get very itchy. I trust my diagnosis because my dermatologist is a professor of dermatology at the Yale University School of Medicine. He said there is no cure and very little research because very few people have this disease. I am currently taking triamcinolone acetonide, which I have to apply to all affected spots twice a day.

Do you know anything about this condition? Can you offer any suggestions?

DEAR READER: Nummular dermatitis (ND) is a form of eczema. It usually occurs on the arms and legs but can appear anywhere on the body. The rash generally starts as papules (raised areas of skin) that then turn into plaques (flattened patches, such as those associated with psoriasis). These areas are generally very itchy and are frequently accompanied by abnormal dryness. The areas are prone to infection, cracking, bleeding and so forth caused by scratching.

There are two peak ages of occurrence. People between 60 and 70 are most commonly affected, with a predominance in men. The second group is individuals between the ages of 20 and 30. Those in this group tend to be female, and many also have atopic dermatitis (common eczema). This disorder is rare in children.

Symptoms often come and go with winter. Cold or dry conditions may worsen the condition, while sun, humidity and the use of strong moisturizers appear to reduce symptoms. Areas of old patches are often where new outbreaks occur. The cause is unknown, but many experts believe many factors may be involved.

Treatment for generalized (over most of the body) ND can include bed rest, oral antibiotics or steroids and being in a cool (not cold) environment. Taking cool or lukewarm baths or showers once or twice daily followed immediately by applying moisturizer can be beneficial. The skin must be damp while the moisturizer is applied to seal the moisture in. Depending on the severity of the outbreak, and whether it is generalized or localized, some sufferers may require oral steroids, antihistamines, sedatives or antibiotics.

Your current treatment of triamcinolone acetonide is a topical anti-inflammatory glucocorticoid, which is essentially a steroid cream. As for suggestions, I am not a dermatologist. In my opinion, you are on an appropriate treatment. Just as there is no cure for common eczema, there is no cure for this form. If you have further questions about prevention, treatment and self-care techniques, I urge you to speak to your physician who, undoubtedly, has access to the newest treatments available.

DEAR DR. GOTT: I recently read your article about cherries for gout and kidney stones. I am a great lover of cherries and use them myself. I feel I have found the solution to the problem of eating cherries when they are out of season and not available fresh in the stores.

During cherry season, I buy them by the large box. I separate them out into freezer bags and freeze them. I often have 100 pounds or more at a time. Whenever I want to eat some or need to because of my gout, I simply take out a handful, wash them (since I don't before freezing) and pop them in the microwave for 30 to 40 seconds. They taste just like fresh ones.

DEAR READER: This is a novel approach to have "fresh" cherries year-'round. Gout appears to respond to nearly any variety of cherry, even dried, canned, maraschino or juice. In my experience, most people like fresh cherries best, so I am passing along your tip. Thanks for sharing.