Follow-Up Care for Nummular Eczema and Hypertrophic Scar: A 37-Year-Old Female Case in Katy & Houston, TX
by: Caroline Vaughn
At Village Dermatology, patient care doesn’t stop after the initial diagnosis. Follow-up visits are crucial for monitoring skin conditions, adjusting treatments, and ensuring optimal long-term results. This case involves a 37-year-old female from the Katy and Houston, Texas area who returned for follow-up after a confirmed diagnosis of nummular eczema and evaluation of a hypertrophic scar.
Patient History
On June 3, 2025, the patient presented with itchy, inflamed skin lesions on her right upper arm and right thigh. A punch biopsy confirmed the diagnosis of nummular eczematous dermatitis. At that time, she was prescribed triamcinolone ointment and given detailed skin care instructions.
The patient also had a biopsied spot on her right upper arm that developed into a thickened, itchy scar—later identified as a hypertrophic scar.
Follow-Up Visit Findings
At her one-month follow-up:
Nummular eczema:
Significant improvement
No new lesions reported
Some hypopigmentation present in treated areas
Hypertrophic scar:
Still thickened and itchy
Intralesional corticosteroid injections (ILK) discussed but deferred due to pregnancy
Understanding Nummular Eczema
Nummular eczema (also called discoid eczema) is a chronic condition that presents as:
Round, coin-shaped patches of inflamed skin
Itching and discomfort
Often triggered by dry skin, fragrance-containing products, and cold weather
In this case, consistent use of triamcinolone ointment and adherence to moisturizing routines led to marked improvement.
Skin Care Recommendations
The patient was counseled to:
Bathe in lukewarm water for 10 minutes or less
Use gentle cleansers such as Dove Sensitive Skin
Moisturize 2–3 times daily with cream-based moisturizers
Avoid scented detergents, fabric softeners, and harsh soaps
Keep fingernails short to reduce scratching damage
Understanding Hypertrophic Scars
A hypertrophic scar is a thickened, raised scar that develops after skin injury or surgery.
Treatment options include:
Intralesional steroid injections (ILK) to reduce thickness and itching
Topical high-potency steroids
Pulse dye laser therapy for redness and vascularity
Since the patient is currently pregnant, ILK injections will be reconsidered after delivery.
Plan Moving Forward
Continue triamcinolone ointment as needed for eczema flares
Maintain a strict moisturizing routine
Monitor scar and reassess for possible ILK treatment postpartum
Follow up as needed for any recurrence or worsening of symptoms
Why This Case Matters for Katy & Houston Residents
Chronic skin conditions like eczema require ongoing care and tailored treatment plans. At Village Dermatology, we focus on:
Accurate diagnosis
Patient education
Safe treatment options, even during pregnancy
Cosmetic and functional scar management
Whether you’re managing eczema, scars, or other skin concerns, our dermatology team in Katy and Houston, TX provides compassionate, expert care.
