Dermatitis herpetiformis

Dermatitis herpetiformis is also sometimes referred to as Duhring’s Disease and is abbreviated as DH. This physical issue is a chronic condition influential on the skin of the body and is characterized by prevalence of blisters. These blisters may be filled with fluid. Most people wrongly believe that the condition is somehow related to herpes virus due to its name, but the name Dermatitis herpetiformis means that it is an inflammatory condition of skin which appears like herpes. This condition was initially described by Dr. Louis Duhring in the year 1884; this is perhaps the reason why it gets the name Durhing’s Disease. In the year 1967 it was discovered that celiac disease and Durhing’s Disease may be associated; however, the exact cause or mechanism was not identified.

The condition is usually found in people ageing 15 to 40 years; however, it may also affect children as well as people ageing over 40 years. It may affect people of both genders equally; this condition may or may not be too common as it may affect 1 person out of 400 people or 1 in 10000 individuals.

Symptoms of dermatitis herpetiformis

Like any other medical condition even Dermatitis herpetiformis is accompanied by certain symptoms. For example an affected individual may experience papulovesicular eruptions or intense itching on the affected region. These conditions may be usually experienced at extensor regions such as butts, scalp, rear neck area, knees and elbows etc. The blisters seen on the skin may vary in size ranging from very tiny bumps to 1 centimeter.

The condition is very itchy it may be overwhelming to avoid scratching the affected skin region. This may also cause the affected individual to scratch away the blisters even before it is examined by the doctor. In some cases one may experience itchiness or inflammation at a particular region even before the blisters start to appear. If the condition is left untreated the severity of the condition may vary drastically. The symptoms of dermatitis herpetiformis may start occurring during early adulthood from twenty to thirty years of age.

Though the first sign experienced under this condition is itchiness or burning sensation, the first visual symptom may be tiny papules or tiny vesicles which may appear like minute red bumps. Here are some regions where such blisters may be experienced:

• Facial region

• Hair line

• Seldom on shoulders

• Lower spinal column

• With in mouth

The rashes may seldom occur on mucous membranes. The symptoms that occur may be mild to intense, but may ebb away if ingestion of gluten is avoided as well as appropriate treatment is adopted. It is essential to avoid gluten consumption through ailments or oral medicines as it may aggravate the condition. The symptoms of the condition are short lasting or chronic and may also be intermittent. The condition may also show symptoms of coelic disease which may include pain in the abdomen or fatigue.

The rash caused by dermatitis herpetiformis may appear and ebb away through the course of three different stages. During the first stage of the condition the affected person may notice discoloration of his/ her skin, at the affected region, to slight extent. In secondary stage of the condition the lesion progresses to transform into group of noticeable papules or vesicles. In the third stage of durhing’s disease the patient usually experiences skin discoloration or slight change in the color of the skin. This may cause the affected skin region to turn darker or else lighter in shade as compared to color on rest of the body. In some cases the crust may be formed as patient tends to scratch the region where blisters are seen.

Diagnosis

There are several diagnosing techniques that may be adopted to determine the prevalence of dermatitis herpetiformis. A simple blood test for IgA antibodies can help in determining the condition. A doctor may also suggest skin biopsy wherein pattern of IgA accumulation in dermal papilla is revealed through immunofluorescene which helps in differentiating other kind of dermatitis from linear IgA bullous dermatosis. These diagnoses should be performed before the affected individual onsets gluten- free diet, or else it may lead to false negatives. In case the affected person is already on gluten- free diet then the person may have to stop his diet for few weeks to undergo diagnosis properly.

Treatment for dermatitis herpetiformis

There are various different techniques that can effectively help in treating dermatitis herpetiformis. It is believed that the condition shows positive response to specific medicines as well as alterations in diet. Dapsone is said to be an effective treatment for most DH patients. The condition responds to dapsone significantly faster and itchiness caused due to the disease is alleviated within two to three days. However, it is said that the treatment has no positive influence on intestinal damages which is caused due to DH.

It is essential to follow a gluten- free diet strictly on doctor’s instruction; this may also be a lifetime necessity to avoid gluten based foods. This will also help in reducing any underlying intestinal damages as well as risk of other abnormalities. After successfully following gluten- free diet for considerable amount of time as suggested by the doctor, your doctor may also instruct you to reduce dapsone or even cease its use based on your health condition. But this cannot be any sooner than one to three years; hence, one should go for routine checkup timely to keep track of your health.

To your information, dapsone is an antibacterial medicine and it is sometime wrongly suggested to patients who are suffering from DH which is not cause by bacteria. There are other treatments that may be suggested by your doctor in case you are intolerant to dapsone. However, it is suggested to regular go for routine checkup to effectively treat dermatitis herpetiformis.