Hi, new user here (Nummular Excema)

[marc 1n1]

I've had a "bad case" of nummular excema since April '09, this year.
My name's Marc and I'm 54 yrs. old.

When I finally got to see a derma doc--my GP and an
associate of his didn't know what it was, and delayed
a diagnosis by weeks--I had gotten
infected by the initial outbreak, one of three quarter dollar
shaped spots, and it had spread all over.
The doc prescribed oral Prednisone and Triamcinolone oint-
ment.  I was on that for nearly the whole month i was
supposed to, but 5 days before the end I started to have
low blood sugar incidents mid morning.  That stuff really
dragged my system down.
The doc left it up to me to get off the med or not.
I did...he said "you're at a low dose now, so it shouldn't
matter much" (10 milligram tabs, I was at one a day.)

Initally that killed off any activity.  But it didn't last long.
In about 10 days I noted these very small hard welts that
would rise up within the boundaries of the original excema
spots.  These were new to me as I hadn't actually examined
myself when the original problem started on my left shin.
These welts as I call them ooze the tan fluid that caused
the infection.  And they can cluster, making it worse. 

Then at some point the doc's PA put me on Clobetasol
ointment.  I"ve been told the corticosteroid ointments
thin the skin so that this stuff can't grow.  I suppose some
of you are familiar with what the results of using this stuff
looks like. 

The patch on my left shin had grown to about 3 by four inches
just after the infection.  And because I had applied latex
bandaids, the other two initial areas that were on each shoulder
--simply dry skin spots that got pink and started to ooze--had
also grown in size, under the plastic.  (Then I started using
the "sheer" bandaids which didn't cause a problem).

At the beginning of September I got worried about using
this Clobetasol stuff--I wasn't monitored or tested--and
it had turned the patch on my left shin into something
resembling leather.  So the PA prescribed Protopic,
which I've been using since, every day mostly twice a day
at 12 hour intervals, much the same as the Clobetasol.

So where I'm at now is; I have over 20 original excema
spots on me that were caused by the infection.  Of these,
only one that I can think of, perhaps two, are free of
irritation.  On some, the Protopic stops the ooze even.
So I've had some peace of mind, because everything,
though at a lower level of irritation, had gotten manageable.
The top layer of dead, ridged skin on the left shin has mostly
come off; then I though, uh oh, I bet it'll try and take hold again.
A couple of days ago, I started to get
new outbreaks in too many new places
and I'm having trouble keeping up with
them.  I find myself putting more and more Protopic on.
(THis is mostly on old excema spots or at their edge.)

I've read the websites dealing with info on drugs, and
am aware of the corticosteroid side effects and dangers.
But I never read the Protopic, except I do know the info
I got with it said in essence, the long term effects are
unknown; or, in coded parlance, after six weeks 'you're
on your own'.  I just passsed the four week mark on the
1st of October.

And I'm getting very concerned because a few of the
welts are rising outside of the old excema spots completely.
When I was using the Clobetasol, I noted that if
I got any more irritation on a particular spot I'd used
the ointment on, it appeared at the periphery or edge
 of the spot, between thin skin and normal.  ANd,
as I say, in the past few days I've found new welts
in greater amounts that are begining to itch.
The weather here in the upper midwest is getting
colder, and I'm dreading what may happen if my skin
gets as dry as it usually does in winter.  After all,
this type of excema takes advantage of dry skin.

I just almost can't bring myself to use any more
coticosteroid ointment.  I used it once at the
beginning of Sept. on my left shoulder and though
it knocked out the irritation for the most part it
also of course thinned the skin AND made my
shoulder sore for a couple of days.

Anyway, any tips you folks might have would be appreciated!

I just can't help think that in my case the dermatologist--who
is chronically overbooked--can't do justice to my case by
A); hading me over to his PA, and B); pushing these
potentially harmful drugs at me and shoving me out the door
(I exaggerate of course), without much in the way of
instruction or precaution in their use. 
Even though I used tiny tiny amounts of the Clobetasol,
it still had fairly profound effects.

So that's my story, sorry it took so long.

[Bamawing]

Hi and welcome!! You are not the only person on here who has dealt with steroids... and refuses to deal with them again. Run a quick search and you'll see what I mean.

Hopefully, you'll gain more than empathy... but I can guarantee that here you can get support and the knowledge that you are not alone.

[marc 1n1]

Thankyou!  I was thinking I may have to not include too many "gory details" in this
post--no need to upset anyone familiar with these problems, unnecessarily.

But yes, I lurked around a bit before I signed on.  Anyway, I appreciate the sentiment.

And I have cut out the corticosteroid ointment use.  I'm still using Protopic.

[lilmiss_p]

Hi Marc

My view is that if you havent had eczema since birth and if it has not been a chronic problem, your body should be able to overcome the problem in its own time, or at least take you into remission for some time.

When you are in the midst of feeling your worst, its hard to imagine that there is light at the end of the tunnel. But there is, and there will be.

Since you have only had this issue since April it must be very confusing since you are searching for answers, therapies etc. Additionally, your body is probably dealing with the effects of the oral Prednisone.

I am no doctor and by no means have answers to everything, but I have tried the natural route with some success.
I would not suggest you stop your Protopic / topical steroid treatment (as some naturopaths do), however I would introduce some kind of alternative therapy into your life to aid your body in getting itself back to where it was and gradually cut down your usage of steroid.

Perhaps introduce some homeopathy, aloe vera juice, yoga (in particular Bikram yoga which is yoga done in 40 degrees heat hence making you sweat and release toxins), a holiday to a warm destination, relfelxology etc

I have also in the past experienced something which was similar to nummular eczema. I found that soaking in a bath with apple cider vinegar in helped my lesions, and I also took the ACV orally.
You may also want to look into juicing greens... I found the book "The PH miracle" by Robert O Young extremely helpful as it made me explore the possibilty of my body being too acidic, and offered solutions in terms of consuming alkali food.

I hope that this response is somewhat helpful, do let us know how you are getting on

Lilmiss_p

[lilmiss_p]

Hi Marc

I forgot to add that I used fucibet on my lesions which worked very well as it is a steroid cream designed to fight an infected area. Maybe this will "zap" your spots and prevent them from returning?

I wouldnt worry too much about thin skinning if you are not using the steroid repeatedly on the same area. Most people on skincell have also agreed that it takes many years to thin the skin.. maybe do a search on this

Good luck

Lilmiss_p

[marc 1n1]

Thanks lilmiss_p; that's a lot of advice! 

Yes, I have Aloe Vera, seems to work well on small skin ruptures.

I've definitely been looking into Yogic breathing--at least--to aleviate stress,
which I also have a lot of.

The PH thing sounds like our old friend Edgar Cayce's advice; making the
body more alkaline than acidic.  I had forgotten about that!

As to the thinning skin, well, I keep wondering when those spots will revert
to normal.  My largest patch has shed some dead skin a couple times.
I just worry it's permanent; but if, as you say, it takes many years of steroid
use, I shouldn't worry so much?  Interesting too is your posit that if I hadn't
had it since birth it will go away---sooner?

I've just returned from the derm.  and they removed an allergy patch test.
Said I had a reaction to lanolin and some other chemical found in soaps
and moisturizers and makeup.  But my moisturizer, which I use 3 times a day
is from the health food store and is mostly tropical oils and a few vitamins.
I have an evaluation on Friday, for the doc's assistant to tell me more.

Thankyou very much for your advice.   

[lilmiss_p]

You mentioned that the largest patch has shed some dead skin - I wouldnt worry about this. Is this after you have used the steriod as it may be the skin build up that is coming off rather than your skin thinning.

I hope you are seeing some improvement or controlled symptoms...

[marc 1n1]

The derm's PA told me that it's the exzema causing the skin to die and flake off.  Personally
I think it's the steroids that did it.  It's looking much better now, and the "plaque" (the large
dark area of exzema, I believe that's what the doctors call it, a plaque), is getting lighter.  I'm
Caucasian and it's less brown.  Over all I have fewer problems since applying more Protopic
at once.  I had been putting on tiny amounts with Q-tips. 

I'm also taking a break from the Protopic two days in a row per week, because there are
no "emergency" areas going on.   But I'm still getting those tiny welts that will later ooze
if I let them grow and multiply.