Discoid Eczema/Nummular Dermatitis Advice

Hi everyone,

I'm basically after management advice here, although I'll explain my condition first.

I've suffered from a skin condition for a few years now. After the standard back and forth on the GP pathway, I eventually had a photo consultation with a Dermatologist who diagnosed it as being Discoid Eczema. I had wondered if it might be Psoriasis, but given the localised and crusty nature of it, I think the diagnosis looks sound. Within a year of developing it, I'd also developed some patches on my scalp, in and around the hairline.

Having initially tried anti-fungals, diprobase, and mild topical corticosteroids, the Dermatologist prescribed Mometasone (moderate topical corticosteroid), a two week course of Erythromycin (antibiotics), and Cetraban as a moisturiser. I also picked up some T-Gel for my scalp.

The antibiotics had no cosmetic impact. The Mometasone helps, without question, and at some sites (most notably the one in and around my ear) it can bring things completely back to how they were before I developed it. In other sites, like the spots on my thigh and calf, it reduces the extent to a degree but never removes it entirely. I use the Cetraban every time I shower, or when occasionally a site becomes very itchy, I will use it for relief.

I do a two week course of the steroids for a "flare up". Some sites go, others reduce, some others it doesn't seem to make much difference. Then, having done my course, I stop and go back to the Cetraban alone. Within 3 weeks, I'm back to the start of the "flare up". I can't really apply either to my scalp, so I tend to use T-gel as a regular shampoo (rather than exactly as it recommends) every second day.

I suspect that the problem is not so much the prescribed treatment, as my method of administration. The original bottle of Cetraban simply said "For use in the shower". The Mometasone "Use for twice a day for two weeks during flare-ups". I work shifts and spend an awful lot of my free time sleeping on other people's couches, so routine isn't something that comes naturally to me.

Is there anyone here who has had the condition, and what were their routines and results? Dermnetz suggests that the condition may either spontaneously disappear, or in some people may stay for many years. Since I'm now firmly in the "many years" camp, it would be nice to know my options, and get some advice.

As a final thought, and I hope people will understand that this is a personal thing that I don't apply to others, I would describe the psychological impact of my condition to me as being "mild". Obviously I'd rather not have it, and if I could get rid of it I would, but it doesn't have a major impact upon my life. As I've said to my friends, now I've hit 30 I can expect to develop at least one chronic health condition sooner or later, and if that's discoid eczema then I will gladly take that and walk away. I'm more concerned with the idea of repeatedly using moderate strength steroids for half of the rest of my life just to not have a gammy ear.

Thanks in advance, and sorry for the small novel.

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