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Dermatitis Herpetiformis – Pictures, Symptoms, Causes, Treatment

Updated on August 18, 2014

Dermatitis herpetiformis refers to a skin disorder, wherein the affected person suffers from an itchy, blistery, burning, and inflamed skin rash. The rash generally affects varied body parts like the buttocks, scalp, back, elbows, and knees. It is also possible for the rash to be a symptom of a more complicated preexisting condition, namely, allergy to gluten.

Dermatitis herpetiformis is also known by other names, i.e., Duhring’s disease or gluten rash.

Symptoms of dermatitis herpetiformis

Dermatitis herpetiformis is regarded as one of the severest forms of itchy rash. Some of the accompanying signs and symptoms are as follows:

  • Appearance of several clusters of distinctive blisters or tiny lumps called papules, as well as flat lesions on affected parts of body. These areas may also undergo skin discoloration.
  • The papulovesicular growths are usually very itchy. They may also cause stinging or burning sensations. Over time, the blisters may develop scabs and then become non-itchy. The above listed symptoms can range from being mild to severe.
  • Dermatitis herpetiformis rashes can affect any skin region. The rashes are however usually spotted as symmetrical skin anomalies that appear on the buttocks, scalp, lower back, shoulders, back of neck, elbows, and knees.
  • Rashes occurring on either the left or right side of the body tend to be of similar size and shape. It may also be noted that people with previous cases of dermatitis herpetiformis may develop future instances of the rash on almost always the same area that was previously affected.
  • Before a full-blown outbreak of rashes, affected individuals may experience burning sensations or itchiness of the skin area which will eventually develop the rash. Later, pimple-like bumps filled with clear fluids form at the spot. These bumps can be easily scratched off.After the passage of some days when the lesions heal, a purple scar is left behind which can remain for a few weeks. But, with the healing of older skin abnormalities, new ones crop up in its place. This situation may persist for several years, marked by periods of remissions and reoccurrences.
  • Some people may also experience various symptoms of celiac disease such as fatigue, unexpected tiredness, and abdominal pain.

Causes of dermatitis herpetiformis

Dermatitis herpetiformis is not caused by any type of herpes virus, even though the name may sound suggestive.

Dermatitis herpetiformis is a skin disorder that typically affects people with celiac disease, which is a condition characterized by gluten intolerance or allergy. Gluten is a form of protein available in varied grains like barley, oats, wheat, rye, etc.

The rash and intestinal anomalies associated with dermatitis herpetiformis are caused due to an allergic reaction of the IgA antibody to gluten proteins. The IgA type antibodies can be typically found in the intestinal linings, eyes, and mouth.

It is a well-known fact that antibodies are produced by the body to fight-off invasion by pathogens and toxins. The body may also sometimes produce antibodies against foods like gluten or nuts, or environmental elements like pollen or dust mites. Individuals with such antibodies are considered as allergic. It may also be noted that hay fever, hives, and other major allergies are caused due to the adverse reaction between the IgE antibody and allergens like pollen, etc.

In people with celiac disease, the IgA antibodies erroneously recognize gluten proteins as harmful and attack them. This can result in substantial damage to the tiny intestinal villi which carry out the function of absorbing nutrients and vitamins. It may be noted that elevated sensitivity to gluten is usually passed down in families.

The process of dermatitis herpetiformis rash formation: The IgA antibodies cling to gluten and pass into the bloodstream. This results in obstruction of the tiny blood vessels, especially those occurring in skin. The clogging of blood vessels attract white blood cells which then release a chemical called ‘complement’ to counter it. This reaction ultimately leads to the development of an itchy, blistery rash.

It is important to note that while women have a higher tendency for celiac disease, men are more prone to developing dermatitis herpetiformis. The abnormal skin condition initially appears in the teens or early 20s. It may also commence during childhood.

Dermatitis herpetiformis is a condition that persists for the patient’s lifetime. It may however go into remission for some time even if an affected person consumes a gluten-rich diet.

Treatment of dermatitis herpetiformis

  • Treatment of dermatitis herpetiformis generally involves the use of an antibiotic drug called dapsone. However, as it is a powerful drug with serious side effects, a physician usually opts for a gradual increase in the dosage over several months till it becomes fully effective.
  • Tetracycline, sulfapyridine, and some kinds of immunosuppressant drugs may also be prescribed to treat dermatitis herpetiformis. However, they are not as effective as dapsone.
  • Eating a gluten-free diet is the best cure for dermatitis herpetiformis. Patients will however need to visit a dietician for recommendations on how to compensate for the loss of nutrients arising due to such a restrictive diet.

Dermatitis Herpetiformis Pictures


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