Dermatitis herpetiformis is also known as Duhring’s disease. It is a reaction in the body of some people against the protein called gluten. Gluten is a flexible protein group. It is found in foods such as wheat, rye, barley and oats. When these foods are consumed, blisters form on the skin surface of people with sensitivity. These appear as water-filled rashes. It is a long-term and recurrent disease. It develops when the immune system attacks one’s own tissues due to gluten sensitivity.
Although the disease is associated with hereditary predisposition, it is not always transmitted from mother and father to child. However, it is more likely to occur in those with a family history of dermatitis herpetiformis and celiac disease. Celiac disease is an intestinal disease caused by hypersensitivity to gluten. Dermatitis herpetiformis can occur at any age. But it is more common between the ages of 20 and 40. It can also occur in childhood.
It is important to consult a dermatologist when the symptoms of the disease are first noticed. Because gluten sensitivity can bring with it other diseases. When diagnosed and intervened early, it is possible to control the problem before it grows.
Causes of Dermatitis Herpetiformis
Dermatitis Herpetiformis results from a genetic predisposition to gluten sensitivity. But just because a parent has a gluten sensitivity doesn’t mean the child will definitely have it. As a result of this sensitivity, intestinal problems cause celiac disease, and skin problems cause dermatitis herpetiformis.
Gluten protein is found in many foods such as wheat, bulgur, oats, rye, cream, cream and ketchup. These foods can cause dermatitis herpetiformis when consumed by a person with a sensitivity.
Dermatitis Herpetiformis Symptoms
The first symptom of the disease is severe itching. It is usually seen with stinging in the affected area. It can cause sleep disorders as it flares up late in the day. After the area is scratched and irritated, small bumps occur on the skin surface. They become water-filled and accompany it with smaller, reddened and closely located blisters. When these formations are itchy, sores may occur and the possibility of infection in the area increases over time.
The areas where itching and blisters occur are usually above the knee and elbow joints, hips, and the back of the shoulders. These areas often occur reciprocally, that is, it can occur on both elbows or both knees. But other areas may also arise. Although it is rare, there is a possibility that it may come out in the mouth.
Symptoms are severe for an average of one week. Then it is seen that the blisters go away and the itching decreases. But the disease often recurs.
How is Dermatitis Herpetiformis Diagnosed?
When diagnosing dermatitis herpetiformis, a dermatologist’s examination is needed first. The doctor evaluates the skin surface, the history of the disease and the symptoms. A skin biopsy is usually needed. A biopsy is done by taking a small piece from the problem area. During the procedure, the area is numbed locally so that the patient does not feel pain.
Then, the sample is examined and a definitive diagnosis is made. After the disease is diagnosed, it can be investigated whether the patient has celiac disease, another disease that can be caused by gluten.
Dermatitis Herpetiformis Treatment
Dermatitis herpetiformis is a long-term disease and recurs when the patient ingests gluten. For this reason, two methods are used in the treatment as drug therapy and diet. Drug therapy is recommended as a drug called Dapsone, which acts quickly to eliminate the symptoms of the disease.
Dapsone is mainly produced against bacteria, but it has also been shown to be effective in the treatment of this disease. If the general health condition of the patient is suitable for the drug, it is prescribed.
In a few days, there is a significant reduction in severe itching. The dose taken is determined according to the patient’s needs. Patients who cannot use dapsone use other drugs with less effectiveness. Gluten-free diet is started along with drug therapy. Diet is a lifelong condition for patients.
When gluten is reintroduced into the body, the symptoms reappear. When the diet is applied without drug treatment, the skin problems go away more slowly. That’s why they are usually started together.
After the diet has been applied for a period of time, the drug is reduced or discontinued. Since the treatment has some side effects and other diseases are common, the patient should see a doctor at regular intervals.
Dapsone can cause anemia, liver and muscle problems.