Dermatitis herpetiformis overview
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Differentiating Dermatitis herpetiformis from other Diseases |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
Overview
Dermatitis Herpetiformis (also called Duhring's disease), is a chronic itchy rash which is frequently associated with Celiac Disease. The rash is made of papules and vesicles which are present on different parts of the body mostly commonly on neck, trunk, buttocks and knees. It is an autoimmune mediated skin condition, which is IgA mediated reaction and is associated with gluten sensitivity of small bowel. There is presence of antibodies which leads to positive serology test results.
Dermatitis herpetiformis is associated with high prevalence of other autoimmune diseases.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Dermatitis Herpetiformis from Other Diseases
Epidemiology and Demographics
Risk Factors
Dermatitis herpetiformis usually begins in people age 20 and older, although children may sometimes be affected. It is seen in both men and women.
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Dermatitis herpetiformis breakouts are usually extremely itchy. In many people the vesicles or papules appear on the elbows, knees, back, and buttocks (pressure points). It may also present as a patch of red skin with little water blisters scattered about. It is a systemic condition; the unpredictable skin rash may appear or be exacerbated by any irritation such as dry skin, scratching or clothing that is rough or scratchy. The fact that the rash is most prevalent at pressure points (where clothing rubs the most) may be why the symptoms sometimes appear to be symmetrical.
Physical Examination
Laboratory Findings
A skin biopsy and direct immunofluorescence test of the skin are performed in most cases; doctors may additionally recommend a biopsy of the intestines.
CT Findings
MRI Findings
Other Imaging Findings
Treatment
Medical Therapy
Dapsone, an antibiotic, may help the majority of patients. A strict gluten-free diet will also be recommended to help control the disease. Adherence to this diet may eliminate the need for medications and prevent later complications.