Dermatitis Herpetiformis: Causes, Symptoms And Treatment

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Dermatitis herpetiformis causes skin lesions and is widely regarded as an immune system disorder. It derives its name due to its clusters which resembles herpes simplex virus disease, but the condition is not caused by a virus. The skin disease affects exterior parts of the limbs and is also commonly seen on the buttocks. Other parts of the body may become affected in serious cases if poorly managed. Papules, vesicles, hives and itching are major discomforts experienced, with a marked level of asymptomatic cases in many individuals. Worldwide distribution of the disease shows that 10 in 100,000 individuals suffer from the condition while a prevalence of 11.2 in 100,000 individuals exists in the United States. The disease also tends to be a common skin disorder in fair-skinned individuals of Northern Europe. It is not common in Africans and Asians and is linked to gluten-sensitive enteropathy – coeliac disease.

Causes

Proteins make an essential food component in our diet. But when it comes to barley, rye and wheat, there might be some cause for concerns. These foods are culprits for development of Dermatitis herpetiformis due to their gluten content.  Gluten enhances the condition by propelling increased production of antibodies and autoimmune pathways that irritate the gut and skin.  Also called Duhring-Brocq disease, Dermatitis herpetiformis is very common in individuals who have coeliac disease. Those with a family history of the disease and similar genetic predisposition are more likely to develop the condition.

And the symptoms?

The skin disease is slightly more common in men than women.  However, it affects more females than males under 20 years. Children are scarcely affected. Dermatitis herpetiformis is predominant in individuals 20 to 40 years of age but can also affect other age groups. Fatigue, diarrhoea, abdominal pains and loss of weight are usually experienced by sufferers.  Symptoms appear symmetrically on affected parts, in clusters and often on the shoulders, scalp, elbows, knees and buttocks. In other cases, thickened plaques and red patches may appear like those of related inflammatory skin conditions. In resolved cases, it is also not uncommon to find hyperpigmentation or hypopigmentation.

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Diagnosis

Due to its semblance of other inflammatory skin conditions such as allergic contact dermatitis (eczema), the condition is normally misdiagnosed. Additionally, not everyone with the condition presents associated lesion symptoms. An advisory step is to always get tested for the condition if eczema treatment seems unhelpful and itching becomes persistent. Biopsies are always a good definitive test for Dermatitis herpetiformis.

Dermatitis herpetiformis Treatment

Treatment basically involves taking a gluten-free diet. This helps reduce gluten related enteropathy – a tripwire for its development. Cutting back on gluten also reduces your cost of medication based treatment and enhances bone density. Your chances of developing intestinal cancers and other autoimmune conditions may also be drastically reduced with a gluten-free diet.

Accompanying rash can be curtailed by using medications as advised by a physician, however, recovery is pretty slow and patience is key during this period. It has been reported that symptoms can continue even with a cut in gluten consumption but it should always be a first choice strategy in Dermatitis herpetiformis treatment

Iodine has also been implicated in worsening the lesions, and thus its consumption should be reduced during recovery. Thus using non-iodized salt should be preferred for meals.

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