Dermatitis Herpetiformis
Dermatitis herpetiformis is an exquisitely pruritic eruption classically seen on the buttocks and the extensor surfaces of the arms and legs and may involve larger surface areas.
Dermatitis herpetiformis is an autoimmune blistering disorder that is often associated with a gluten-sensitive enteropathy. Other names: Duhring disease, Duhring-Brocq disease, gluten rash.
Dermatitis herpetiformis is characterized by grouped excoriations, erythematous, urticarial plaques, and papules with vesicles. The classic location for dermatitis herpetiformis lesions is on the extensor surfaces of the elbows, knees, scalp, buttocks, and back. It is extremely pruritic, and the vesicles are often excoriated to erosions by the time of physical examination.
Male to female ratio 2:1. The onset of dermatitis herpetiformis is in the second to fourth decade. But persons of any age may be affected. Dermatitis herpetiformis is rare in children. One in 10 patients with dermatitis herpetiformis has a family history of it, or of coeliac disease.
Dermatitis herpetiformisis is one of the itchiest rashes possible. Common locations of the rash include: elbows, knees, lower back, hairline, back of the neck, shoulders, buttocks, and scalp.
The rash is usually the same size and shape on both sides of the body and often comes and goes.
Before a full outbreak of the rash, may feel the skin in a rash-prone area burn or itch. Intense itching is the first and main symptom. Bumps that look like pimples filled with clear liquid start to form. These are quickly scratched off. The bumps heal within a few days and leave a purple mark that lasts for weeks. But new bumps continue to form as old ones heal. This process can continue for years, or it can go into remission and then return.
Symptoms of an associated coeliac disease may be present in a minority of those with dermatitis herpetiformis, but are usually mild. They may include weight loss, abdominal discomfort and pale-coloured bowel motions.
While these symptoms are commonly associated with dermatitis herpetiformis, they can also be caused by other skin conditions such as atopic dermatitis, irritant or allergic contact dermatitis, psoriasis, pemphigoid, or scabies.
Dermatitis herpetiformisis associated with a bowel disorder known as coeliac disease (also called celiac sprue, gluten intolerance, or gluten-sensitive enteropathy). Dermatitis herpetiformis is an autoimmune blistering disorder. Virtually all patients with dermatitis herpetiformis are likely to have subtle changes to this condition. In some, it will be clinically apparent, but in most, it will be so mild that it causes no symptoms and may only be demonstrated by a biopsy of the intestine. In both dermatitis herpetiformis and coeliac disease, patients are allergic to gluten, a protein found in wheat, rye and barley flour and in some other grains such as couscous and bulghur. It’s also sometimes found in oats that have been processed in plants that handle other grains. An allergic reaction to gluten plays an important part in causing the rash of dermatitis herpetiformis.
Dermatitis herpetiformisis can be treated with an antibiotic called dapsone (50 to 200 mg per day). Dapsone is a powerful medicine with serious side effects. The dose must be increased slowly over several months before it’s fully effective.
Other drugs that may be used include tetracycline, sulfapyridine, and some immunosuppressive drugs. These are less effective than dapsone.
The most effective treatment that’s free of side effects is strict adherence to a gluten free diet. This means, completely avoid food, drink, or medicines containing: wheat, rye, barley, oats.
Although this diet can be difficult to follow, it will have the most beneficial effect on health if have celiac disease. Any reduction in gluten intake may help lessen the amount of medication that will need to take.
To confirm the diagnosis, need to visit a doctor. After diagnosis, need to consult with a gastroenterologist and a diet specialist to suggest about diet. Patient must consult with a dermatologist about treatment.
- ABC Of Dermatology
- Clinical Dermatology
- Roxburgh’s common skin diseases
- Andrew’s Diseases of the skin
Dermatitis Herpetiformis
TUI - Tibot Urgency Index
Dermatitis herpetiformis is an exquisitely pruritic eruption classically seen on the buttocks and the extensor surfaces of the arms and legs and may involve larger surface areas.
Dermatitis herpetiformis is an autoimmune blistering disorder that is often associated with a gluten-sensitive enteropathy. Other names: Duhring disease, Duhring-Brocq disease, gluten rash.
Dermatitis herpetiformis is characterized by grouped excoriations, erythematous, urticarial plaques, and papules with vesicles. The classic location for dermatitis herpetiformis lesions is on the extensor surfaces of the elbows, knees, scalp, buttocks, and back. It is extremely pruritic, and the vesicles are often excoriated to erosions by the time of physical examination.
Male to female ratio 2:1. The onset of dermatitis herpetiformis is in the second to fourth decade. But persons of any age may be affected. Dermatitis herpetiformis is rare in children. One in 10 patients with dermatitis herpetiformis has a family history of it, or of coeliac disease.
Dermatitis herpetiformisis is one of the itchiest rashes possible. Common locations of the rash include: elbows, knees, lower back, hairline, back of the neck, shoulders, buttocks, and scalp.
The rash is usually the same size and shape on both sides of the body and often comes and goes.
Before a full outbreak of the rash, may feel the skin in a rash-prone area burn or itch. Intense itching is the first and main symptom. Bumps that look like pimples filled with clear liquid start to form. These are quickly scratched off. The bumps heal within a few days and leave a purple mark that lasts for weeks. But new bumps continue to form as old ones heal. This process can continue for years, or it can go into remission and then return.
Symptoms of an associated coeliac disease may be present in a minority of those with dermatitis herpetiformis, but are usually mild. They may include weight loss, abdominal discomfort and pale-coloured bowel motions.
While these symptoms are commonly associated with dermatitis herpetiformis, they can also be caused by other skin conditions such as atopic dermatitis, irritant or allergic contact dermatitis, psoriasis, pemphigoid, or scabies.
Dermatitis herpetiformisis associated with a bowel disorder known as coeliac disease (also called celiac sprue, gluten intolerance, or gluten-sensitive enteropathy). Dermatitis herpetiformis is an autoimmune blistering disorder. Virtually all patients with dermatitis herpetiformis are likely to have subtle changes to this condition. In some, it will be clinically apparent, but in most, it will be so mild that it causes no symptoms and may only be demonstrated by a biopsy of the intestine. In both dermatitis herpetiformis and coeliac disease, patients are allergic to gluten, a protein found in wheat, rye and barley flour and in some other grains such as couscous and bulghur. It’s also sometimes found in oats that have been processed in plants that handle other grains. An allergic reaction to gluten plays an important part in causing the rash of dermatitis herpetiformis.
Dermatitis herpetiformisis can be treated with an antibiotic called dapsone (50 to 200 mg per day). Dapsone is a powerful medicine with serious side effects. The dose must be increased slowly over several months before it’s fully effective.
Other drugs that may be used include tetracycline, sulfapyridine, and some immunosuppressive drugs. These are less effective than dapsone.
The most effective treatment that’s free of side effects is strict adherence to a gluten free diet. This means, completely avoid food, drink, or medicines containing: wheat, rye, barley, oats.
Although this diet can be difficult to follow, it will have the most beneficial effect on health if have celiac disease. Any reduction in gluten intake may help lessen the amount of medication that will need to take.
To confirm the diagnosis, need to visit a doctor. After diagnosis, need to consult with a gastroenterologist and a diet specialist to suggest about diet. Patient must consult with a dermatologist about treatment.
- ABC Of Dermatology
- Clinical Dermatology
- Roxburgh’s common skin diseases
- Andrew’s Diseases of the skin
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