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Dermatitis herpetiformis

Dermatitis herpetiformis (DH) or Duhring's Disease, is a skin disorder often associated with celiac disease. It is a chronic, extremely itchy rash consisting of papules and vesicles. Dermatitis herpetiformis is associated with sensitivity of the intestine to gluten in the diet (celiac sprue). more...

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Dermatitis herpetiformis usually begins in the twenties, though children may sometimes be affected. It is seen in both men and women. Though the cause of the rash is unknown, dermatitis herpetiformis is frequently associated with gluten (a protein found in cereals) sensitivity in the small bowel.

Symptoms

Dermatitis herpetiformis is usually extremely itchy. The vesicles or papules usually appear on the elbows, knees, back, and buttocks. In most cases, it is highly symmetric. Symptoms of dermatitis herpetiformis tend to be sporadic.

Signs and tests

A skin biopsy and direct immunofluorescence test of the skin are performed in most cases. Your doctor may additionally recommend a biopsy of the intestines.

Treatment

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.

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Dermatitis Herpetiformis
From American Family Physician, 5/15/01 by Anne D. Walling

(Canada--Canadian Family Physician, November 2000, p. 2199.) Dermatitis herpetiformis is an autoimmune skin condition in which deposits of IgA form at the epidermal-dermal junction. The condition is often associated with gluten sensitivity and gastrointestinal symptoms. Histologically, the papillary dermal tips are edematous and separate from the epidermis. Patients present with chronic, intensely itchy vesicles and pustules on the extensor surfaces of the arms and legs. As vesicles are broken, lesions can become crusted and secondarily infected. Chronic lesions may become hyper- or hypopigmented. Mucous membranes are usually not affected. Clinically, dermatitis herpetiformis can resemble scabies, atopic dermatitis or neurotic excoriations. Treatment with dapsone can dramatically improve the condition, and many patients also benefit from a gluten-free diet.

COPYRIGHT 2001 American Academy of Family Physicians
COPYRIGHT 2001 Gale Group

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