Brief Answer: Kindly elaborate and send pictures Detailed Answer: Hello, Welcome and thanks for posting your query to the forum. I can understand your concern for the skin condition. Before I can answer your query can you please help me in some of the more information so that I can guide you best regarding your query: - Was the diagnosis of "nummular eczema" was confirmed by a dermatologist. - Since how long you have the aforesaid condition of nummular eczema. Can you please elaborate how these started and do they started simultaneously or one after the other. - Are these persistently present since its appearance or any of these disappeared completely any time. - What is the grade of itching, redness and scaling- mild /moderate/ severe. - What all treatment you have taken to treat the condition. In view to help you best I suggest you to upload few good resolution pictures of your affected areas. For that you have a feature to upload images by yourself at the right side of the query page. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia. Hope to hear soon from your side. Wish you good health. Regards. Dr Sanjay Kumar Kanodia MD (Dermatology & STD)

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Brief Answer: Condition can be treated by simple steroid creams Detailed Answer: Hello, Welcome again and thanks for posting the important informations. Though I required conforming the diagnosis of nummular eczema by pictures but considering your facts, letting me guide you accordingly. Nummular eczema is a skin entity where we see circular or oval plaques of eczema with a clearly demarcated edge. In most of the cases the cause is unknown but it is considered to an internal tendency of a person to have allergic phenomenon which is regarded as a primary endogenous form of eczema. Sometimes it is considered to be due to infection by bacteria. That is why an allergic sensitivity to bacteria such as staphylococci or micrococci may be responsible at least for secondary dissemination and further formation of new lesions. We quite often see that due to scratching and local physical or chemical trauma produced by it plays an important role. Even dry skin due to low environmental humidity is sometimes associated with discoid eczema particularly in your age group. An association between excessive alcohol intake and discoid eczema has been seen, so alcohol intake can be an important factor. Emotional stress may play a role in some cases. You can notice that I have enumerated the important of the causes of nummular eczema. In none of the causes you can find that it is related to surgery. So considering your facts as well the informations provided by me, surgery is no where applicable in your case or any other case of nummular eczema. Surgery is not at all a mode of treatment in nummular eczema. In my patients I generally prescribe a high potency steroid first and then shift it to medium to low potency steroid cream in few weeks of period. Additionally a moisturizer cream is to be applied daily of r8-10 times to reduce the intensity to itch and also to reduce the dryness. -I would have preferred to give an oral anti histamine like loratadine two times a day if there is moderate to severe itching is present. Don't try to scratch or rub the area as can lead to further aggravation of the problem. So you can get that by simple measure and prevention of the aggravating factors along with simple medicines the problem of nummular eczema can be controlled and treated. Do not at all think of surgery for the management of this condition. I hope these information's will help you. If you have further queries I will be happy to help. "Wish you good health and early recovery from the problem" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology & STD)

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