Dermatitis herpetiformis Duhring
Dermatitis Duhring, also called herpetiformis dermatitis, is a chronic recurring skin disease, which manifests itself in the form of various morphological elements, such as bubbles, erythematous spots, blisters, papules.
Rash accompanied by severe itching and burning, they gather in groups. Exact diagnosis is made after histological examination of the analysis of urine and the reaction of the immunological studies.
In the treatment of this disease using a sulfonic group means, as well as corticosteroids.
Dermatitis Duhring can be observed at different ages, but most often it affects people 30-40 years, though the male population are more susceptible to this disease than women.
In some cases, the disease reaction of the skin in the human body malignant tumor on the internal organs, this kind of manifestation palaontologisches forms of dermatosis.
Why the disease develops
Still not an explicit cause of the disease and not the mechanism of its distribution. Many patients suffer from immunity to the protein's gluten, which is found in plants of the family Gramineae.
About the autoimmune origin of the disease indicates the presence of IgA antibodies in the boundary area of the epidermis and dermis is the basement membrane.
Suppose that some value in the development of this disease is hypersensitivity to iodine, hereditary factor, the presence of ascariasis, inflammation in the gastrointestinal tract (ulcer, gastritis) as well as viral infections (herpes, SARS).
Signs of dermatitis herpetiformis Duhring
Typically, this disease is characterized by acute form in the beginning, you can see that the centers of polymorphic forms of rashes. Before the appearance of the rash may slightly rise the body temperature, there is weakness, tingling, itch, as in the photo.
Rashes may appear on different skin areas excluding the hands and feet. However, they are most often located on the flexor parts of the feet and hands, shoulder blades, back, shoulders, buttocks.
But the palms may appear ekhimozy, as well as petechiae in the form of spots of subcutaneous effusions of blood, the size of which reaches 3 mm. Rash accompanied by severe itching, burning, or paresthesia, it can be seen in the photo.
Mucosa, mainly when the disease is not affected. Rarely in the mouth may appear bubbles, which soon turned into erosion.
The true manifestation of the polymorphism of the rash in this disease is based on the simultaneous appearance of the skin papules, spots, bubbles and blisters erythematous form.
Withover time to the present polymorphism is added deceptive: in connection with the transformation of the rash appear brown and erosion. In addition, due to intense scratching of the skin appear excoriation. When lesions heal, on the skin's surface there are areas of Hyper - hypopigmentation and sometimes scarring.
Form erythematous patches in this disease are round with a clear outline. The surface of the spots is smooth, often cover the scratching, scabs bloody, serous kind.
Over time to them is the effusion from the vessels that are dilated, they become like blisters. Then the blisters grow and turn into pink and blue spots, which cover the crust, vesicles, scratching.
In addition to the erythematous spots may be converted into papules rich pink-red color. It should be said that the appearance of papules and rashes can occur, bypassing the stage of formation of erythematous patches as pictured.
The rash blisters during disease, dermatitis herpetiformis Duhring are in the form of small vesicles about the size of a 2 cm – bullous rash. Their fluid fills the transparent color, if it becomes cloudy, then – added infection.
Bubbles burst, form a crust after drying. While combing the cortex is damaged, in place of the bubble occurs erosion.
Depending on what kind of rash more share these kinds of diseases suitable for dermatitis herpetiformis:
- vesicular form;
- papular form;
- urtiertoba form;
- bullous appearance.
- There are atypical forms of the disease:
- eczematoid form;
- tropologia form.
Acute stage of the disease alternate remission, which can last for quite a long period of time (several months or a year or more). At exacerbation there is often General deterioration, increased body temperature, poor sleep.
How to diagnose dermatitis herpetiformis Duhring?
If you suspect the presence of this disease take iodine analysis of Elassona. Intact skin is a compress containing ointment, which is half of iodide of potassium. A day later the wrap is removed.
If in its place is detected by redness, papules, it indicates the presence of the disease in dermatitis herpetiformis Duhring. If the analysis gave a negative result, do it again. Then 2 days later applied the same compress on the area of pigment spots, which remained after the old rash. Also, by the way, you can use the disease is characterized by the presence in the blood increased number of eosinophils. Cytological examination of the content contained in the bubbles,also revealed elevated levels of eosinophils. But these figures are not guaranteed to indicate the presence of disease.
To more reliable methods of diagnosis of the disease in dermatitis herpetiformis is the skin analysis that shows under the skin region, where the accumulated neutrophils, eosinophils, and destroyed the remnants of their cores. At reaction direct immunofluorescence revealed IgA deposits in the upper part of the dermal papillae.
In the diagnosis of bullous disease need to share it from other forms bullous dermatitis, such as bullous pemphigoid, pemphigus vulgaris and other forms of pemphigus.
Because the disease dermatitis herpetiformis dühring applies to palaontologischen disease, for elderly patients it is preferable to conduct additional studies to rule out cancer damage to internal organs, namely: ultrasound of the gastrointestinal tract, and pelvic organs, performed radiographs of the lungs and so on.
Therapy disease dermatitis herpetiformis Duhring
Patients attributed to appropriate therapy at the dermatologist's. Dr. is a diet that excludes cereals, foods, their composition must be iodine (seafood, salad, sea fish). Treatment with medicines is based on medicines sulfonic groups:
- diucifon and others.
These funds are usually credited to be taken orally for 5 days, the gap is 1 to 3 days. If the positive effect is not observed, therapy is corticosteroids (dexamethasone, prednisone). For getting rid of itching use effective antihistamines: zyrtec, claritin and aerius.
Local treatment consists of warm baths with potassium permanganate, then the bubbles opened and treated with antiseptic or fukortsin, is then applied corticosteroid ointment, is treated with a spray, use dermatology ointment and cream for dermatitis.
If you suspect the occurrence of the disease should immediately consult a doctor.