Dermatitis Herpetiformis - Causes, Symptoms & Treatment

Dermatitis Herpetiformis Alternative name Duhring's disease. Dermatitis herpetiformis is a chronic, extremely itchy rash consisting of bumps and blisters. The disease is characterized by the presence of IgA deposits in the upper dermis skin and the diagnosis should not be made in the absence of these deposits. The HLA-B8 gene is found in 80% of patients with gluten enteropathy and dermatitis herpetiformis. Dermatitis herpetiformis is linked to sensitivity of the intestine to gluten in the diet (celiac sprue). Dermatitis Herpetiformis is a disease of the skin. It is caused by deposition of IgA in the papillary dermis. This triggers an immune cascade, including recruitment of neutrophils and complement into the area. Dermatitis herpetiformis is an autoimmune blistering disorder associated with a gluten-sensitive enteropathy (GSE). It is characterized by grouped excoriations; erythematous, urticarial plaques; and papules with vesicles. 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 has recently been proposed as a cutaneous manifestation of asymptomatic-to-mild CD. The genetic predisposition to the development of gluten sensitivity underlies the disease. Most DH patients can usually predict the location of a new lesion as much as 8 to 12 hours before the actual onset because of the symptoms of localized burning and itching. Lesions occurring on the lips and within the mouth, it is extremely unusual for lesions to occur on mucous membranes (soft tissues at body openings) in other areas of the body. hese lesions tend to occur in groups much like the lesions of Herpes, hence the term herpetiformis, meaning "like Herpes." Because of the intense itching, the lesions are often scratched; these scratched areas will then develop crusts and often then heal with changes in color, either those of hypopigmentation or hyperpigmentation. Lesions may first appear as discolorations and next consist of small bumps called papules and small blisters called vesicles.

Causes of Dermatitis Herpetiformis

Common causes of Dermatitis Herpetiformis

• Triticeae.
• Gluten enteropathy.
• Gastric atrophy.
• Gastric hypochlorhydria.
• Pernicious anemia.

Symptoms of Dermatitis Herpetiformis

Common Symptoms of Dermatitis Herpetiformis

• Dry skin.
• Scratching.
• Clothing.
• Lesions.
• Itchy.
• Rash (bumps and blisters).

Treatment of Dermatitis Herpetiformis

Common Treatment of Dermatitis Herpetiformis

• Other, less effective treatments for DH include colchicine, cyclosporine, azathioprine, and prednisone. Cyclosporine should be used with caution in patients with DH because of a potential increase in the risk of developing intestinal lymphomas.
• Nonsteroidal anti-inflammatory drugs may exacerbate DH; however, ibuprofen appears to be safe.
• Iodides may elicit or exacerbate DH.
• Dapsone (diaminodiphenyl sulfone) and sulfapyridine are the primary medications used to treat DH.

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