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Dermatitis Herpetiformis - Causes, Symptoms and Treatment


Dermatitis herpetiformis, is a skin disorder often associated with celiac disease. It is characterized by urticarial plaques and blisters on the elbows, buttocks, and knees. It is associated with sensitivity of the intestine to gluten in the diet.

It 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. It is also known as Brocq-During disease, dermatitis multiformis, Duhring disease, and gluten-sensitive enteropathy.

Dermatitis herpetiformis is usually occurs in young adults, it is seen in both men and women but is more common in men and people originally from some areas of northern Europe. The HLA-B8 gene is found in 80% of patients with gluten enteropathy and dermatitis herpetiformis.

It is characterised by skin lesions, with intense itching and burning sensations.

Causes of dermatitis herpetiformis:

The most common causes of dermatitis herpetiformis are as:-

  • Dermatitis herpetiformis is caused by proteins called glutens, which is mainly found in foods containing wheat, barley, or rye.
  • The immunologic abnormalities may also lead to the condition of dermatitis herpetiformis. The presence in lesions of IgA (immunoglobulin) and complement components supports an immunoregulatory disturbance.
  • The some halides, such as iodide may cause a flare to dermatitis herpatiformis.
  • It usually occurs in middle adult life. A slow onset during adulthood is typical, but children can be affected. Males are affected more than females.
  • The patient, who is suffering from celiac disease, is more prone to get affected by dermatitis herpetiformis.

Symptoms of dermatitis herpetiformis:

The possible symptoms of dermatitis herpetiformis are as:-

  • DH can be characterized as an intensely itchy skin eruption, mostly on the elbows, knees, buttocks, scalp, posterior, neck, sacral (lower end of the spinal column) and shoulder areas.
  • Most individuals will also have some damage to their intestines.
  • The iron deficiency i.e. anemia, may come in the patients of dermatitis herpetiformis.
  • The weakness, weight loss are common during dermatitis herpetiformis.
  • The patient may feel having red bumps and blisters. The blisters and papules mainly occur on the face and neck.
  • The important symptoms that are associated with dermatitis herpetiformis includes as: diarrhea, thinness, malnutrition, pot belly.
  • The constipation may be seen in some cases of dermatitis herpetiformis.
  • The lesions may first appear as discolorations and next consist of small bumps called papules and small blisters called vesicles. These lesions tend to occur in groups.
  • Ingestion of gluten plays a role in the exacerbation of skin lesions.
  • The occurance of fatty stools, gives the indication about the dermatitis herpetiformis.
  • You may have the feeling of abdominal pain in chronic condition.
  • The bone becomes more fragile and you may have the feeling of bone pain.

Treatments for dermatitis herpetiformis:

The effective treatments for dermatitis herpetiformis are as:-

  • The best treatment for dermatitis herpetiformis involves the use of dapsone to treat the rash. Dapsone is a drug that will improve DH in days. This brings symptomatic relief within 1 or 2 days.
  • Topical steroid creams, lotions, and ointments to reduce inflammation. These medications are effective.
  • Calamine lotion and similar agents can reduce itching and irritation. It reduces the requirement for dapsone.
  • A strict gluten-free diet is strongly recommended to reduce the risk of gastrointestinal lymphoma and developing other autoimmune conditions.
  • Tetracycline, is an alternative treatment for dermatitis herpetiformis.
  • Cool-water soaks to soothe irritation and decrease itching.
  • Antihistamines reduce itching and may allow you to rest more easily. They may cause drowsiness, so use these agents cautiously when driving or performing other activities in which you must be awake and alert.
  • The sulfapyridine is the primary medications used to treat DH.
  • The other 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.
  • Ultrapotent topical steroids, are also beneficial for the fast recovery from DH.