Diseases

Dermatitis Herpetiformis Duhring – Causes, Symptoms & Treatment

Dermatitis herpetiformis Duhring

Dermatitis herpetiformis Duhring is a chronic skin disease. It is characterized by the formation of blisters on various parts of the body and is accompanied by severe itching. Many patients with Duhring’s disease suffer from the inflammatory small bowel disease celiac disease. Dermatitis herpetiformis Duhring is the skin manifestation of this clinical picture. Certain ointments and lotions as well as a lifelong diet can be used for therapy.

Was ist Dermatitis herpetiformis Duhring?

Dermatitis herpetiformis Duhring or Duhring’s disease is a chronic skin disease. The clinical picture is characterized by blistering on the inside of the arms and legs. The disease is rather rare.

It occurs more frequently in middle age. Men are affected more frequently than women. The disease is chronic. Your symptoms can always come back. In many cases, the intensity of the symptoms lessens over the years.

causes

The causes of the disease are not yet fully understood. A genetic predisposition cannot be ruled out. The disease can be triggered by iodine or gluten. People who suffer from this skin condition should definitely be tested for celiac disease , as these two diseases are associated with each other.

Celiac disease, also known as gluten-induced enteropathy, is an intolerance to the gluten protein in various types of grain. Those affected show characteristics of an autoimmune disease and an allergy . Consuming gluten leads to chronic inflammation of the mucous membrane in the small intestine. This hypersensitivity reaction is lifelong. Dermatitis herpetisformis Duhring is the skin manifestation of the disease.

Symptoms, Ailments and Signs

At first, many sufferers develop hives-like rashes . The sufferers complain of severe itching on the affected areas of the skin. In addition, clearly recognizable reddening of the skin is typical of the clinical picture.

Blisters gradually form on the reddened areas of skin. These can spread to adjacent skin tissues and form crusts. The nodules on the skin’s surface are a few millimeters wide and develop into the blisters characteristic of the skin disease after about seven to ten days.

Typical areas of the body where blisters form are the abdomen, thighs, extensor sides of both arms, buttocks, sacrum and shoulder girdle. Blistering on the mucous membranes is rarely observed. In only a few cases are the neck, back or face affected.

The blisters are initially clear and later cloudy and may be filled with blood. The sensitive reaction to the trace element iodine is characteristic of the disease. In most cases, exposure of a patient to iodine results in a dramatic worsening of symptoms. In addition, patients suffering from dermatitis herpetiformis Duhring have celiac disease. This can be asymptomatic or with the occurrence of increased fatty stools .

Diagnose

Due to the rather unspecific symptoms, especially at the beginning of the disease, dermatitis herpetiformis Duhring is often recognized late. In order to make a diagnosis, similar diseases must first be ruled out. These include the so-called erythema exsudativum multiforme .

This disease describes an inflammation of the dermis. To confirm the diagnosis of dermatitis herpetiformis Duhring, a biopsy is taken in healthy skin tissue. In order to be able to make the diagnosis with certainty, evidence of so-called granular IgA deposits is necessary. The tissue removed for this purpose must be examined in a special laboratory.

Since many patients suffering from Duhring’s disease also suffer from celiac disease, diagnostics must also be carried out with regard to this clinical picture. For this purpose, certain antibodies in the blood are determined. In addition to the detection of gliadin and endomysial antibodies, the patients are examined for transglutaminase IgA antibodies.

In addition, a biopsy of the small intestine must be performed to confirm the diagnosis. Most patients suffering from Duhring’s disease have a rather harmless course of celiac disease. However, in a few, massive fatty stools, osteoporosis and vitamin deficiencies can occur.

complications

Dermatitis herpetiformis Duhring is a rare, incurable autoimmune skin disease. The symptom is not age-related and makes men ill more often than women. In Scandinavia, Hungary, England and Ireland in particular, the disease occurs more frequently than in Germany.

Therefore, there is a suspicion that dermatitis herpetiformis Duhring is a hereditary disease. There may also be a connection with intestinal diseases due to gluten intolerance. In addition, tumor formation, infections, and exposure to iodine seem to promote the symptom.

Dermatitis herpetiformis Duhring starts with reddening of the skin. If the symptom is ignored by the person concerned or treated incorrectly on their own initiative, painful swelling and unpleasant itching develop. The symptom affects the limbs, but also appears on the head, upper body, sacrum and buttocks, but very rarely on the mucous membranes. As a real complication, the affected areas become inflamed and form abscesses.

These enlarge into fluid-filled skin blisters. The blisters become encrusted due to the increasing, burning itching. The course develops chronically. With timely medical clarification, complications can be largely ruled out. In medical therapy, a lifelong gluten-free diet is recommended. Drugs based on sulfone or cortisone and lotions are administered according to tolerance.

When should you go to the doctor?

In the case of hives-like rashes and other signs of dermatitis herpetiformis Duhring recommends a visit to the family doctor . Redness of the skin, severe itching and blisters are also symptoms that indicate a serious skin disease and must be clarified accordingly. If swelling and abscesses form as a result of incorrect or inadequate treatment, it is best to go to the nearest clinic. This is especially true if the blisters fill with liquid or become crusted.

In the case of a chronic course, regular visits to the doctor are indicated, which is why the disease is best diagnosed and treated in the early stages. After a tumor disease as well as infections and contact with iodine, dermatitis herpetiformis Duhring occurs particularly frequently.

To whom these factors apply, you should consult a doctor immediately with the symptoms mentioned. In addition to the family doctor, the dermatologist or a specialist in internal medicine can also be contacted. In medical emergencies – for example, if sepsis develops or heavy bleeding occurs – the medical emergency service is the right contact person.

Treatment & Therapy

The itchy regions of the skin are usually treated with the sulfone dapsone . As a rule, most patients are free of symptoms within a short time after this application. Dapsone can have side effects. The therapy should therefore be supported by regular blood value checks.

Since the disease can be aggravated by iodine, foods rich in iodine should be avoided, especially at the beginning. These include certain sea fish species. The affected skin areas and the itching can also be treated with soothing ointments or lotions. In some cases, short-term treatment with cortisone preparations is induced. Permanent special care of the skin is not necessary for dermatitis herpetiformis Duhring.

Since in most cases celiac disease is the basis of dermatitis herpetiformis Duhring, this disease must be treated with the same therapy. For those affected, this means giving up the gluten protein for the rest of their lives. Even the smallest amounts can drastically worsen the course of the disease.

Gluten is the glue protein of certain grains. The sufferers must therefore avoid the cereals wheat, rye, barley, spelled, kamut, einkorn, emmer and unripe spelt. Products made from these products, such as couscous or pasta, must also be left out. Maize, millet, rice, quinoa, soya and buckwheat are expressly permitted. Products that do not contain gluten are marked with the addition “gluten-free” and can be consumed without hesitation.

Outlook & Forecast

With a consistent change in diet, patients with dermatitis herpetiformis Duhring have a good prognosis. In many cases, further medical care is usually not necessary. In the case of more severe symptoms, medicines help to alleviate the skin changes or the itching. However, these are associated with side effects. A regular blood test is therefore advisable in order not to trigger any further diseases.

The patient can achieve freedom from symptoms of dermatitis herpetiformis Duhring for life of their own accord and self-determined drive. For this purpose, the food supply must be checked. All diet must be gluten-free for a good prognosis. For the favorable prospect of healing, no product may be consumed that contains even the smallest amounts of gluten. It takes a few months to a year to be completely gluten-free for the body to recover.

A recurrence of the symptoms occurs immediately if gluten has been consumed. Therefore, there is always a risk in the course of life of experiencing a recurrence of the symptoms. There is an increased risk, especially when eating food in restaurants. Without renouncing gluten, the patient can fall victim to a chronic course of the disease. The general state of health is weakened and the susceptibility to illness is greatly increased. The quality of life decreases and in everyday life there are significantly more difficult health conditions.

prevention

Prevention of the disease is only possible to a limited extent. Since dermatitis herpetiformis Duhring is associated with celiac disease and high iodine exposure, it is conceivable that a special diet throughout life could reduce the likelihood of the skin disease.

aftercare

In the case of dermatitis herpetiformis Duhring, the affected person usually has no special options and measures for aftercare. The person concerned is primarily dependent on full medical treatment in order to alleviate the symptoms and avoid further complications, since self-healing is also not possible.

Only early diagnosis and prompt treatment can prevent the symptoms from getting worse. In most cases, dermatitis herpetiformis is treated with medication, ointments or creams. The person concerned should always follow the doctor’s instructions and also observe the regularity and dosage of the medication.

If you have any questions or are unclear, you should always contact a doctor first. If the symptoms of dermatitis herpetiformis Duhring do not go away within a few days, you should definitely consult a doctor. Since the disease can also lead to psychological upsets or depression, intensive discussions with friends or with one’s own family are often very useful. In serious cases, however, professional advice from a psychologist makes sense. As a rule, dermatitis herpetiformis Duhring does not reduce the patient’s life expectancy.

You can do that yourself

Despite the difficult diagnosis, everyone affected can do a few things to improve their quality of life. Self-discipline is important as the symptom of itching should not be given in to. Scratching creates open wounds that germs can enter. In addition, the skin damage increases. The person concerned should therefore, for their own sake, ensure that they use ointments if the itching is too severe and therefore not tempted.

The skin changes lead to an optical flaw. This can reduce self-esteem . It is advisable to obtain comprehensive information about the disease and to find ways to ensure that the aesthetic demands of the person concerned can be maintained. Conversations and tips with other sufferers or close relatives often help.

It can be beneficial to find out their attitude and perception of the skin changes. In many cases, the person concerned perceives the visual flaw to be worse than it is perceived by those in the immediate vicinity. Changing cognitive patterns can therefore alleviate emotional distress.

Although scientifically insufficient, it appears that a special diet could be beneficial to one’s recovery. This must take place throughout life and can contribute to a significant improvement in symptoms and an increase in one’s own well-being.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.