<\/span><\/h2>\nDermatitis herpetiformis is a rare but persistent immunobullous disease that has been linked to celiac disease (the American spelling is celiac), a gluten-sensitive enteropathy.<\/p>\n
The name herpetiform is derived from the tendency for blisters to appear in groups, similar to herpes simplex. However, dermatitis herpetiformis<\/span> it is not due to viral infection<\/span>.<\/p>\nHerpetiform dermatitis<\/span> It is also known as Duhring-Brocq disease.<\/p>\n<\/span>Who gets dermatitis herpetiformis?<\/span><\/h2>\n\n- \nHerpetiform dermatitis<\/span> It predominantly affects Caucasians 15 to 40 years old, but can occur in young or old and other races.<\/li>\n
- There is a 2: 1 male to female ratio.<\/li>\n
- More women under the age of 20 are affected than men.<\/li>\n
- There's a genetic<\/span> predisposition<\/span> with an association with humans White blood cell<\/span> antigens<\/span> (HLA<\/span>) DQ2 and DQ8.<\/li>\n
- Some patients have a personal or family history of others autoimmune<\/span> diseases like thyroid disease, pernicious anemia<\/span>, type 1 diabetes, vitiligo, Addison's disease and alopecia<\/span> areata.<\/li>\n<\/ul>\n
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<\/span>What causes dermatitis herpetiformis?<\/span><\/h2>\n\n- reherpetiform dermatitis<\/span> and celiac disease are due to intolerance to the gliadin fraction of gluten found in wheat, rye, and barley.<\/li>\n
- Gluten triggers IgA production antibodies<\/span> and an autoimmune process that targets the skin and intestine.<\/li>\n
- In celiac disease, gluten causes the intestine inflammation<\/span> resulting in diarrhea, tiredness, weight loss, and abdominal discomfort.<\/li>\n
- Most (> 90%) of patients with dermatitis herpetiformis<\/span> They also have gluten sensitive enteropathy. Gastrointestinal symptoms can be mild to severe; some patients remain symptom<\/span>-free.<\/li>\n
- About 15-25% of celiac patients have concurrent<\/span> dermatitis herpetiformis<\/span>. These patients tend to have a more severe intestine. pathology<\/span> compared to those with mainly dermatitis herpetiformis<\/span>.<\/li>\n<\/ul>\n
<\/span>What are the clinical features of herpetiform dermatitis?<\/span><\/h2>\n\n- reherpetiform dermatitis<\/span> have a symmetrical<\/span> distribution<\/span>.<\/li>\n
- Injuries most often appear on the scalp, shoulders, buttocks, elbows, and knees.<\/li>\n
- It is characterized by prurigo<\/span> (extreme itching papules<\/span>) and vesicles<\/span> on normal or reddened skin.<\/li>\n
- They often appear in groups or serpiginous<\/span> bunches<\/li>\n
- The blisters often erode and form crusts due to immediate scratching.<\/li>\n
- reherpetiform dermatitis<\/span> It can also be presented initially as digital petechiae<\/span>.<\/li>\n
- Flat, thickened red spots plates<\/span> and cure<\/span> can occur similar to another inflammatory<\/span> skin conditions such as dermatitis, scabies and papular<\/span> urticaria<\/span>.<\/li>\n
- Injuries resolve to leave post-inflammatory<\/span> hypopigmentation<\/span> and hyperpigmentation<\/span>.<\/li>\n<\/ul>\n\n
<\/span>Herpetiform dermatitis<\/span><\/h5>\n<\/section>\n\n\n
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<\/span>What are the complications of dermatitis herpetiformis<\/span> and celiac disease?<\/span><\/h2>\nThe following conditions may affect patients with dermatitis herpetiformis<\/span>, especially when associated with celiac disease:<\/p>\n\n- \n
Aphthous ulcers<\/span> and angular cheilitis\n<\/li>\n- \n
Dry skin, nails and hair<\/span> abnormalities<\/li>\n- Dental problems: fine enamel<\/li>\n
- \nNeurological <\/span>problems: ataxia (loss of balance), polyneuropathy, epilepsy<\/li>\n
- Heart problems: pericarditis<\/span> and cardiomyopathy<\/span>\n<\/li>\n
- \nRecurrent<\/span> miscarriages (miscarriage)<\/li>\n
- Fatty liver resulting in abnormal liver function tests<\/li>\n
- * No Hodgkin lymphoma<\/span> (NHL) * that affects the intestines or any part of the body<\/li>\n<\/ul>\n
* NHL risk increases between dermatitis herpetiformis<\/span> Patients Strict adherence to the gluten-free diet reduces this rare but serious complication in the long term.<\/p>\n\n
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<\/span>How is dermatitis herpetiformis diagnosed?<\/span><\/h2>\n<\/span>Skin biopsy<\/span>
\n<\/span><\/h3>\nSkin biopsy is usually necessary to confirm dermatitis herpetiformis<\/span>. Characteristic histological<\/span> appearances of dermatitis herpetiformis<\/span> They are:<\/p>\n\n- Subepidermal blisters<\/li>\n
- \nNeutrophils<\/span> and eosinophils<\/span> inflammatory cells in dermal<\/span> papillae<\/span>\n<\/li>\n
- Granular IgA deposits in the dermal papillae by direct contact immunofluorescence<\/span>\n<\/li>\n<\/ul>\n
<\/span>Detection of nutritional deficiencies.<\/span><\/h3>\nPatients with dermatitis herpetiformis<\/span> They are commonly offered the same blood tests that are used for celiac disease patients to detect nutritional deficiencies. These include:<\/p>\n\n- Complete blood count, liver function tests, and serum<\/span> calcium<\/li>\n
- Iron, zinc, vitamin B12 and folic acid.<\/li>\n
- Thyroid function tests<\/li>\n<\/ul>\n
Mild anemia can be caused by iron or folic acid deficiency (or both) due to malabsorption associated with gluten-sensitive enteropathy. Thyroid function tests are generally recommended because of the association between dermatitis herpetiformis<\/span> and thyroid disease.<\/p>\n<\/span>Diagnostic blood test<\/span><\/h3>\nSpecific autoantibody<\/span> tests for dermatitis herpetiformis<\/span> They are:<\/p>\n\n- IgA anti-endomysial antibodies<\/li>\n
- IgA tissue transglutaminase antibody<\/span>, tTG<\/li>\n
- * IgA epidermal<\/span> antibodies to transglutaminase, eTG (when available)<\/li>\n
- Gliadin deamidated IgA and IgG peptide<\/span> antibody, dGP<\/li>\n
- Gliadin IgA and IgG Assay<\/li>\n
- Total IgA level<\/li>\n<\/ul>\n
* *Herpetiform dermatitis<\/span> It is associated with IgA antibodies directed against epidermal transglutaminase (eTG), which is not the case in celiac disease.<\/p>\nLimiting results can be difficult to interpret.<\/p>\n
<\/span>Small intestine biopsy<\/span><\/h3>\n\n- \nHerpetiform dermatitis<\/span> Patients with abnormal blood results generally undergo a biopsy of the small intestine to confirm gluten-sensitive enteropathy.<\/li>\n
- This is histologically<\/span> characterized by the downy small intestine atrophy<\/span>. This means that instead of being very complicated, the lining of the intestines is smooth and flattened.<\/li>\n
- The intestine may appear normal due to treatment (gluten-free diet and \/ or medication), omission injuries (the sample was taken from an unaffected site), or the intestine may not be affected by the disease.<\/li>\n<\/ul>\n
<\/span>Other tests<\/span><\/h3>\nHLA haplotype, a set of DNA<\/span> variations, tests can reveal HLA-DQ2 or HLA-DQ8. This is present in almost all patients with dermatitis herpetiformis<\/span> (and celiac disease).<\/p>\n<\/span>What is the treatment for dermatitis herpetiformis?<\/span><\/h2>\n<\/span>Gluten free diet<\/span><\/h3>\nA lifelong gluten-free diet is strongly recommended in patients with dermatitis herpetiformis<\/span>, such as:<\/p>\n\n- Reduces medication requirement to control<\/span> dermatitis herpetiformis<\/span>\n<\/li>\n
- Improves associated gluten associated enteropathy<\/li>\n
- Improves nutrition and bone density.<\/li>\n
- May reduce the risk of developing other autoimmune diseases<\/li>\n
- It can reduce the risk of intestinal lymphoma.<\/li>\n<\/ul>\n
<\/span>Medicine<\/span><\/h3>\nDapsone is the treatment of choice for dermatitis herpetiformis<\/span>, since it generally reduces itching in 3 days.<\/p>\n