Dermatitis herpetiformis is an intensely pruritic (itchy) skin disease characterized by eruptions of clusters of small blisters or vesicles (small elevations of the skin containing fluid) and small bumps or papules (small, solid, elevations on the skin). Dermatitis herpetiformis typically presents in the fourth of fifth decade of life, although it can occur at any age. It affects more men than women, and is a lifelong condition.
Despite its name, the herpes virus does not cause DH. Dermatitis herpetiformis is caused by an allergy to gluten. When gluten, a protein found in wheat and grains, is consumed it combines with IgA (an antibody) from the intestines and they begin to circulate in the blood stream together. They ultimately end up clogging small blood vessels in the skin, causing a rash to develop. The disease typically occurs in people of northern European heritage. People with DH often have a high incidence of autoimmune thyroid disease.
There is no known way to prevent this disease. People who suffer from DH may be able to prevent complications by avoiding foods that contain gluten. Although this is very difficult to do, adherence to a gluten-free diet can reduce the amount of medications needed to manage the disease.
The following are the most common symptoms of dermatitis herpetiformis. However, each individual may experience symptoms differently. Symptoms may include:
The gut may also have the same allergy to gluten. This is known as celiac disease or gluten sensitive enteropathy (GSE). A person can have both GSE and DH together or only one. Some cases of GSE become cancerous. Because of this, if you have celiac disease, it is important to have an evaluation by a doctor who specializes in the stomach and intestines (a gastroenterologist).
The symptoms of DH may resemble other skin conditions. Always consult your doctor for a diagnosis.
In addition to a medical history and physical examination, DH is usually confirmed with a skin biopsy with immunofluorescence (a specialized type of stain which helps to detect the presence of IgA antibodies) and sometimes a blood test.
Dermatitis herpetiformis may be well-controlled with treatment. Specific treatment for DH will be determined by your doctor based on:
The symptoms of dermatitis herpetiformis may clear when all gluten is eliminated from the diet, although healing may take several weeks to months. Treatment may also include drug therapy. Dapsone, a medication which can improve symptoms by suppressing the skin response, may be prescribed. However, dapsone has been associated with some side effects, especially anemia. If Dapsone is prescribed for you, your doctor will carefully monitor your blood count.
Click here to view the
Online Resources of Dermatology