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.