An Investigator-initiated Study of Apremilast to Demonstrate Efficacy Nummular Eczema

Inclusion Criteria: 1. Clinically confirmed diagnosis of nummular eczema 2. Biopsy-proven, meaning histology consistent with eczema (including PAS-staining) 3. PGA ≥ 3 on a 5 point scale 4. History of continuous use of topical steroids for the last 8 weeks 5. Age 18-85 years of age, body weight ≥ 40 kg and ≤ 160 kg 6. Signed informed consent from patient Exclusion Criteria: 1. Permanent severe diseases, especially those affecting the immune system 2. Pregnancy or breast feeding 3. History or presence of epilepsy, significant neurological disorders, depression, suicidal ideation and behaviour, cerebrovascular attacks or ischemia 4. History or presence of myocardial infarction or cardiac arrhythmia which requires drug therapy 5. Evidence of severe renal dysfunction defined as: * eGFR \< 30 ml/min/1,73 m2 (calculated using the MDRD formula) at screening (Visit 1) 6. Evidence of significant hepatic disease defined as: At screening (Visit 1): * Alkaline phosphatase \>3x upper limit of normal (ULN) or alkaline phosphatase \>2,5x ULN and total bilirubin \> 2xULN or * Aspartate transaminase (AST, SGOT\]) and alanine transaminase (ALT, SGPT\]) \> 2.5x upper limit of normal (ULN) 7. History of lymphoproliferative disorders 8. Patients who are considered potentially unreliable or where it is envisaged the patient may not consistently attend scheduled study visits 9. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant unless they use effective contraception during the study and for 4 weeks after study completion or discontinuation. The chosen form of birth control must be effective by the time the patient receives her first dose of study drug. 10. Inability or unwillingness to undergo repeated venipuncture (e.g., because of poor tolerability or lack of access to veins) 11. Inability or unwillingness to undergo repeated punch biopsies 12. History of allergy to any component of the study medication 13. Current use of strong cytochrome P450 enzyme inducers (eg, rifampicin, phenobarbital, carbamazepine, phenytoin and St John's wort) 14. Patients with rare hereditary problems of galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption 15. Evidence of acute contact dermatitis at screening 16. Evidence of underweight, defined as BMI \< 18,5 kg/m2 17. Evidence of Zink deficiency defined as Zink level \< 20 µg/dL in serum