WHAT IS DERMATITIS HERPERTIFORMIS ?

 WHAT IS DERMATITIS  HERPETIFORMIS ?

Dermatitis herpetiformis { DH } causes itchy bumps and burning blisters . Those with a sensitivity to gluten , like people with celiac disease , might  get this skin condition . Although the lesions look similar to herpes,  its a  completely different condition . Managing the symptoms requires  a gluten free diet .  



Dermatitis herpetiformis , is a long term  skin condition   that  causes itchy  bumps and blisters . The  direct cause of dermatitis  herpetiformis is a sensitivity to gluten . Gluten is found in common foods such as  wheat , rye  and barley . Dermatitis  herpetiformis patients usually don't have the digestive  symptoms that go along with celiac disease . Dermatitis herpetiforms is sometimes called the skin manifestation of celiac disease . Diarrhea , exhaustion , weightloss and abdominal discomfort are all symptoms of celiac disease . 

WHAT ARE THE CAUSES OF DERMATITIS HERPETIFORMIS ?

Patients with dermatitis herpetiforms have an autoimmune reaction when they eat gluten .  When gluten is digested , the immune system is triggered. Antibodies are produced, which subsequently  deposit in the skin . This causes the itchy , red bumps and blisters commonly  seen in dermatitis herpetiformis . Genetics play a role in dermatitis herpetiformis. 


WHAT ARE THE SIGNS AND SYMPTOMS OF DERMATITIS HERPETIFORMIS ?

Dermatitis herpetiformis have one or more of three problems : Skin problems , problems in your mouth and gastrointestinal problems . 




SKIN PROBLEMS : Skin problems are the most common and the key sign of dermatitis herpetiforms . Problems  include  red bumps and itchy , sometimes burning blisters. skin problem are found on your elbow buttocks , knees and scalp . 

ORAL PROBLEMS : Dermatitis herpetiformis can cause tooth enamel problems . it may be pitting , discoloration , horizontal grooves and rarely  canker  sores . 

GASTROINTESTINAL PROBLEMS : Celiac disease inflames and damages the small intestine . almost all people with dermatitis herpetiformis are sensitive  to gluten and have celiac disease but are less  likely to have gastrointestinal issues . Patients have some symptoms may have bloating , cramping , diarrhea , constipation and pain . 

 HOW TO TREAT DERMATITIS HERPETIFORMIS ?

FIRST-LINE THERAPY :

A strict gluten free diet must be followed , and usually , this treatment will be a lifelong requirement. avoidance of gluten will  reduce any associated intestinal damaged and the risk of other complications . it can be very difficult  to maintain a strict  glutn- free  diet , however , as contamination with gluten is common in many supposedly gluten free foods and restaurants . 
An effective initial treatment in most people and is the initial drug of choice  to alleviate the rash and itching . Itching is typically reduced within 2-3 days daposed treatments has no effect  on any intestial damage  that  might be present . 

ALTERNATIVE TREATMENTS OPTIONS :

For individuals with DH  unable to tolerate  dapsone for any reason ,  alternative treatment options many include the following :
  • colchicine 
  • lymecycline 
  • nicotinamide 
  • tetracycline 
  • sulfamethoxypyridazine 
  • sulfapyridine 
Combination therapy with nictinamide and tetracyclines has been  shown to be effective and well tolerated in some individuals who cannot tolerated dapsone or live in places where  dapsone is not  readily  available . The mechanism of actions of  tetracyclines and nicotinamide in DH is  unknown , it is speculated to be due to their immune - modulating effects . 


PROGNOSIS OF DERMATITIS HERPETIFORMIS :

Dermatitis herpetiforms generally responds well to medication and a strict gluten  free diet . It is an  autoimmune disease,  and thus individuals  with  DH are more likely to develop  other  autoimmune  conditions such as thyroid disease , insulin - dependent  diiabetes , lupus  erthematosus , sarcoidosis , vitiligo, and  alopecia areate . 
Dermatitis herpetiformis does not usually cause complication on its own , without being  associated  with another condition . Complication from this conditions  arise from the autoimmune character of the disease , as an   overreacting immune system is a sign  that something does  not work  well and might cause problems to other  parts of the body that do not necessarily involve the digestive system . 

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