Dermatitis herpetiformis (Dh) is a skin disorder often connected with celiac disease. (Dh) is an intensely itchy skin eruption. Dermatitis herpetiformis normally begins in persons age 20 and older, although children may sometimes be affected. It is seen in both men and women. It normally shows up in young adults, and is more coarse in men and people originally from some areas of northern Europe. It has been hypothesized that Dh is the consequent of an immunologic response to continuing stimulation of the gut mucosa by dietary gluten with subsequent activation of cutaneous endothelial cells and circulating inflammatory cells, including neutrophils. Dh was at one time described in the literature as Duhring's Disease. Some chemicals have been connected with induction of Dh, including potassium iodide and cleaning solutions. It has a typical onset in the teens or in the third or fourth decades of life. In the U.S., the presence of diagnosed cases is estimated to be about 1 in 10,000 with a male/female ratio of 2:1. It is more coarse in whites and rare in people of African or Asian descent. If you have Dh, you all the time have gluten intolerance. With Dh, the customary lesion is on the skin, whereas with celiac disease the lesions are in the small intestine.
Symptoms of dermatitis herpetiformis are intense burning, stinging and itching around the elbows, knees, scalp, buttocks and back. More locations can also be affected and the severity can vary. Scratching will supplementary irritate the eruptions. Eruptions ordinarily occur on pressure points, such as around the elbows, the front of the knees, the buttocks, back face, and scalp but can appear everywhere on the body. Eruptions are normally bilateral - occurring on both sides of the body. Ingestion of gluten plays a role in the exacerbation of skin lesions. Small blisters normally make gradually, mostly on the elbows, knees, buttocks, lower back, and back of the head. Sometimes blisters break out on the face and neck. The rash may be small lumps, like insect bites (papules), some with tiny fluid filled blisters on top. These small blisters are called vesicles. Any way it can also appear hive-like, continuing in one area, or it may look like a pink and scaly dermatitis. The fact that the rash is most prevalent at pressure points (where clothing rubs the most) may be why the symptoms sometimes appear to be symmetrical. Typically, the onset of Dh is in the second to fourth decade; however, persons of any age may be affected.
Potassium IOdide
Dermatitis herpetiformis is frequently connected with gluten (a protein found in cereals) sensitivity in the small bowel. This means that instead of being extremely convoluted, the lining of the intestines is flat and flattened. Gluten is a protein present in grasses of the species Triticeae, which includes barley, rye, and wheat. Rice and oats belong to dissimilar species and are ordinarily well tolerated. Hormonal factors may also play a role in the pathogenesis of Dh. Androgens have a suppressive consequent on immune activity, including decreased autoimmunity, and androgen deficient states may be a inherent trigger for Dh exacerbation. IgA circulating immune complexes are present in 25-35% of patients with Dh, although no relationship with disease severity has been noted. These immune complexes also have been noted in patients with isolated Gse and are believed to be connected to the presence of the gut disease. connected autoimmune diseases contain dermatomyositis, type 1 diabetes mellitus, myasthenia gravis, rheumatoid arthritis, Sjögren syndrome, systemic lupus erythematosus, and thyroid abnormalities. Thyroid abnormalities are present in as many as 50% of Dh patients and contain hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid cancer.Gastric manipulation (surgery) may induce Dh.
There is a very productive treatment available for dermatitis herpetiformis. A gluten-free diet is very difficult to achieve; however, limiting intake of wheat, barley, or rye products can lessen the symptoms. Dapsone can be connected with severe hematologic (blood) disturbances and must be intimately monitored. However, accurate long-term avoidance of dietary gluten has been shown to cut the dose of dapsone required to operate the disease and may even eliminate the need for medication. In addition, a gluten-free diet may cut the risk of gastrointestinal lymphoma. Other, less productive treatments for Dh contain colchicine, cyclosporine, azathioprine, and prednisone. Uv light may furnish some symptomatic relief. Cyclosporine should be used with caution in patients with Dh because of a inherent increase in the risk of developing intestinal lymphomas. Nonsteroidal anti-inflammatory drugs may exacerbate Dh; however, ibuprofen appears to be safe. Gulphapyridine or sulphamethoxypyridazine have been used to suppress the skin manifestation. It takes Some months for the skin to enhance on these drugs and they do not safe against the serious complication of gluten hypersensitivity.
Dermatitis Herpetiformis - Definition, Causes, Symptoms and rehabilitation
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