Dermatitis Herpetiformis - Definition, Causes, Symptoms and Treatment

Definition

Dermatitis herpetiformis is also known as Duhring’s Disease. It is chronic extremely itchy rash consisting of papules and vesicles. It is associated with sensitivity of the intestine to gluten in the diet. Usually it starts in the age of twenties. Sometimes children are also found affected. It is common in both men and women. There is strong evidence that the changes in the intestinal mucosa and the immunologic findings in the majority of patients diagnosed with DH are identical with those found in celiac disease.

Dermatitis herpetiformis characteristically affects the scalp, buttocks, elbows and knees but lesions may arise on any area of skin. Extremely itchy bumps (papules) and blisters (vesicles) up to 1 cm in diameter arise on normal or reddened skin. The severity can vary from week to week but it rarely clears up without specific treatment.

Causes

1. Heredity: Celiac disease runs in the family. You inherited the tendency to get this disease from your parents. If 1 member of your family has celiac disease, about 1 out of 10 other members of your family are likely to have it.
2. Dermatitis herpetiformis is frequently associated with gluten (a protein found in cereals) sensitivity in the small bowel.
3. It is likely to be caused in age of twenties. But sometimes children can also be affected.
4. It is more likely in men than in women.
5. Patients with DH and no apparent GI disease can be induced into developing DH by increasing gluten intake, which is often termed latent GSE (CD).

Symptoms

1. In this disease Small blisters, itchy, smooth lesions resembling hives appear symmetrically on the head, elbows, knees, lower back, and buttocks. Mostly blisters and papules occur on the face and neck. Itching and burning may be almost intolerable, and the need to scratch irresistible.
2. In most cases, the rash is the same size and shape on both sides. Symptoms of dermatitis herpetiformis tend to get worse and get better.
3. Small blisters usually develop gradually. Anti-inflammatory drugs may worsen the rash.
4. This problem can cause more problems in the body of patient. It can cause iron deficiency, weakness, weight loss, bone pain, white flecks on the fingernails.

Dermatitis Herpetiformis Treatment

1. The blisters do not go away without treatment. So an appropriate treatment is necessary.
2. Standard treatment frequently involves the use of dapsone to treat the rash. This brings symptomatic relief within 1 or 2 days. The urgent need to scratch usually abates in 1 to 3 days.
3. The gluten-free diet is seriously restrictive and compliance may be difficult. Foods with gluten include wheat, oats, rye, and barley.
4. Once the disease has been brought under control with drugs and the person has followed a strict gluten-free diet (a diet that is free of wheat, rye, and barley) for 6 months or longer, drug treatment usually can be discontinued.
5. Other less effective treatments are colchicine, cyclosporine, azathioprine, and prednisone. These medicines has side effect too.