It’s been suggested that the different types of eczema - including discoid dermatitis - count as autoimmune diseases; here we look at the facts behind the claim.

What is discoid eczema?

Discoid eczema is a type of eczema or dermatitis. Also known as nummular eczema, the condition is notable for the way its lesions form circular or oval discs. Starting off as bumpy or blistered spots, the eczema grows outward in rings, with the outer edge often being intensely itchy or inflamed, often weeping then crusting over. The condition can affect adults of any age, but is slightly more commonly found in men over 55. Discoid eczema isn’t infectious, although it can get infected.

What causes discoid eczema?

As with any type of eczema, what causes a flare of discoid can vary from person to person. For many people the condition is associated with atopic dermatitis, as well as other conditions such as hay fever and asthma, with which it can co-exist. Flares can be triggered by things like:

• Injury to the skin (insect bites, cuts, burns, surgery)
• Environmental conditions (very cold or dry weather)
• Stress
• Certain medications
• Contact with irritants 

However, even knowing what can trigger or exacerbate a flare doesn’t explain the root reason why some people get discoid eczema and others don’t. It doesn’t seem to have any genetic component, but it is a chronic condition that can persist for months or years; once someone has suffered one attack of discoid eczema, they’re likely to have more.

How is the immune system involved in discoid eczema?

All eczema involves the immune system to some extent, as the problem is about an overactive immune system response to a stimuli or trigger of whatever sort. This over-reaction triggers inflammation and itchiness, which leads to damage to the skin. 

The same process happens with discoid eczema: the triggers (injury, stress, irritants etc.) set off an inflammatory response which leads to itchiness and inflammation.

What is an autoimmune disease?

Autoimmune diseases are conditions where the body’s immune system ends up attacking itself, either with an exaggerated or an underactive immune system response. Some autoimmune diseases only affect one organ (ie Type 1 diabetes, where the immune system destroys the pancreas), but others (like lupus) are systemic, and damage organs throughout the body.

Many people who have an autoimmune disease are more likely to have eczema as well.

Eczema and autoimmune disease

It’s becoming more widely accepted that eczema, including discoid eczema, isn’t just associated with various autoimmune diseases, but counts as one itself. It is characterised by inflammation, by damage to an organ (the skin), and by an inappropriately reactive immune system response. 

So, in conclusion, although not everyone would acknowledge it as such, it does seem that discoid eczema, as a chronic inflammatory skin condition, is autoimmune in nature. It can’t be cured, but can be managed, and the severity and frequency of flares reduced. 

See our article How Do You Get Rid Of Discoid Eczema? for more information about treatments and management strategies.

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