Jinyuan Pan, Hongmin Yu, Wenjia Ye, Yiyun Liang
In this case, acupuncture was temporally associated with progressive relief of pruritus and near-complete resolution of nummular eczema lesions after a limited response to short-term conventional pharmacological treatment. Acupuncture may be considered as a potential adjunctive option for selected patients, but controlled studies are required to clarify its specific efficacy and safety.
BACKGROUND: Nummular eczema, also known as nummular dermatitis or discoid eczema, is a chronic inflammatory dermatosis characterized by coin-shaped or discoid eczematous plaques with pruritus, most commonly affecting the extremities, particularly the lower legs. Persistent itch, barrier dysfunction, and repeated scratching may impair sleep and quality of life. Direct evidence for acupuncture in the treatment of nummular eczema remains limited.
CASE PRESENTATION: A 68-year-old woman presented with symmetrical coin-shaped erythema, scaling, and infiltrated plaques, accompanied by severe pruritus on the lateral aspects of both lower legs for more than 1 month. Previous oral doxycycline, antihistamines, and potent topical corticosteroids had provided limited benefit. At presentation, the visual analog scale (VAS) score was 8; the retrospective assessment of the baseline clinical photographs yielded an Investigator's Global Assessment (IGA) score of 3. The clinical diagnosis was nummular eczema. She received manual acupuncture at bilateral Quchi (LI11), Xuehai (SP10), Zusanli (ST36), Yanglingquan (GB34), Zulinqi (GB41), and Xiangu (ST43), three times weekly for a total of six sessions.
OUTCOMES: Pruritus and skin lesions improved progressively. VAS scores decreased from 8 at baseline to 3, 1, and 0 at the second, fourth, and sixth treatment visits, respectively; retrospective IGA scores based on the available clinical photographs decreased in parallel from 3 to 2, 1, and 0. By treatment completion, the bilateral lower-leg lesions had almost resolved, with only mild residual pigmentation. No clinically apparent adverse events occurred. At 4 and 12 weeks after treatment, the patient reported no obvious recurrence of pruritus or skin lesions.
CONCLUSION: In this case, acupuncture was temporally associated with progressive relief of pruritus and near-complete resolution of nummular eczema lesions after a limited response to short-term conventional pharmacological treatment. Acupuncture may be considered as a potential adjunctive option for selected patients, but controlled studies are required to clarify its specific efficacy and safety.