Dühring's herpetiform dermatitis - diagnosis, treatment, photo
- 11 Jul 03:45
- Disease Of The Skin
Dühring's herpetiform dermatitis is a disease that belongs to the group of dermatoses herpyforms. This group includes diseases that have different causes, but are similar to clinical manifestations. For all herpetiform dermatoses, including for dermatitisDühring, characteristic specific group of rashes is characteristic.
The disease was named after the famous dermatologist from Philadelphia Duhering( Duhring), who studied his study at the end of the XIX century. Dühring's disease is not a rare disease, it occurs in all age groups. Representatives of a strong sex suffer from herpetiformular dermatitis more often than women.
Duing's disease has a chronic course lasting 20-30 years. For herpetiform dermatitis, periods of prolonged remission, characterized by exacerbations, are characteristic.
With proper treatment of Dühring's dermatitis, the process is gradually dying, remission periods become more and more prolonged. If Duhering's illness begins in childhood, then involuntary treatment is often seen until the end of puberty.
- 1 Causes of
- 2 Clinical manifestations of
- diagnostic methods 4
- treatment methods 5 Treatment with folk recipes
- 6 Forecast and prevention of
- 7 Photo
The exact causes of herpetiform dermatitis have not been identified so far. It is believed that the Dühring disease is a polysystemic disease, has an autoimmune nature. Some dermatologists believe that in the development of dermatitis Duhring great importance is the hereditary factor.
Confirmation of this theory is that in the majority of patients with herpetiformular dermatitis, gluten-sensory enteropathy( non-inflammatory bowel disease caused by hypersensitivity to gluten glands) is detected. In addition, a certain role in the development of duodenal dermatitis plays a high degree of sensitivity to iodine. The autoimmune nature of herpetiform dermatitis is confirmed by the presence of IgA in the tissues of the dermis.
Clinical manifestations of
The first symptoms of Dühring's disease are generalized health conditions. Patients experience a burning sensation of the skin, itching, tingling. Many have fever, a general weakness. Some time after the onset of these sensations there is a rash.
Dying's dermatitis rash is very diverse. These can be erythematous spots, nodules, papules, tensed bubbles. The rash is arranged, both on the skin that is invariably unchanged, and on the swollen, reddened areas.
Diring dermatitis is usually located on symmetrical parts of the body. The most typical localization sites, shoulders, buttocks, waist, inner side of elbows and knees, face, head, including the hairy part.
Externally, rashes in Duing's disease are very similar to herpes, so the disease got the second name - herpetiform dermatitis. With Dühring's disease there is no isolated lesion of the mucous membranes, however, along with the appearance of skin rashes, sometimes there are changes in the palate and mucous membranes.
Rash persists for 3-4 days, after which bubbles are spontaneously disclosed. On the skin, erosions with characteristic festonchy edges are formed. With During's disease, pain is poorly expressed, the Nicholas syndrome( the separation of layers of the epidermis with slight mechanical effects on the skin) is negative.
For during dermatitis, rash polymorphism is characteristic. However, one type of rash, as a rule, prevails. Therefore, in dermatology, it is recommended to isolate the papular, vesicular, bullous, and urticar-like forms of Dühring's disease.
Elements of the rash that appear in herpetiform dermatitis are different from other manifestations of dermatosis. Erythematous spots in Duing's disease have a rounded form with clear borders, small size, smooth surface. Papules and urethra-like rashes with herpetiform dermatitis may have a whimsical form, festonchatye edges with clear boundaries. As a rule, rashes have a pinkish-red color.
Blisters with herpetiform dermatitis are small in size and have a thick, tight coat. The contents of the bubbles are transparent, later it may cloud. Sometimes the content is hemorrhagic, and when the infection is infused becomes purulent.
With herpetiform dermatitis, bubbles are usually exposed on day 4 with the formation of soaking erosions surrounded by scum of bubble covers. Upper peripheral growth of bubble rash with dermatitis Dühring is not susceptible.
Erosion is fairly quickly covered with crust, after which dropping out spots with altered pigmentation, rarely - scars.
Diagnosis of Düring's disease is based on the study of clinical manifestations of the disease. Typical signs of herpetiform dermatitis, distinguishing it from other dermatoses:
- Polymorphism of rash.
- Group bubble location.
- Absence of acantholytic cells.
- Flow Cycle.
- High degree of sensitivity to iodine preparations.
- Presence of eosinophilia in the contents of the vesicles.
To confirm the diagnosis of herpetiform dermatitis, the following studies are conducted:
- Quantitative analysis of eosinophils in the contents of the bubbles and in the blood.
- Jadasson test - iodine test. The test consists in applying an external ointment of potassium iodide( 50%) and ingestion of potassium iodide( solution 5%).If after reception signs of exacerbation of skin reactions are marked, the test is considered positive.
If the herpetiform dermatitis is difficult to escape, the internal test is not carried out, as taking the iodine can cause a sharp aggravation.
It is necessary to differentiate Dühring's disease from diseases such as:
- This is an acantolytic blister.
- Nonacantholytic pumice.
- Bullous Toxidemia.
- Multimorphic erythema.
Treatment methods for
Typically, when using Dyuring's dermatitis, it is usually prescribed diamino-diphenylsulfonic drugs - Dapson, Avlosulfon, and others. When intolerance to these drugs is recommended to prescribe drugs containing sulfopyridine.
In the severe course of Durming's dermatitis, or if the above-described therapy does not produce results, the administration of corticosteroids for intake is indicated. To remove it it is necessary to select antihistamines.
External treatment of herpetiform dermatitis is the use of aniline dyes, ointments containing corticosteroids. Vitamin therapy, vitamin B12 is especially useful as a curing agent.
Patients with herpetiformular dermatitis are important to adhere to a diet with the exception of products containing gluten( oats, millet, barley, wheat and flour from these cereals) and iodine( sea fish, sea cabbage, seafood).
Treatment using folk recipes
For the treatment of Dühring's disease, phytopreparations with anti-inflammatory, antihistamines, reparative effects can be used. These are grasses, like aris, sweet, violet tricolor, mistletoe, juniper, calendula, bitter bird, sea buckthorn.
Since Dühring's disease is often accompanied by a decrease in the functions of the immune system, it is recommended to use infusions and decoctions made of Eleutherococcus, Levsey, Aralia.
For local treatment, it is recommended to use a healing ointment, made from the internal smoked pork fat with the addition of grass belladonna( component ratio - 2 to 1).In the melted fat, dry grass is added, the composition is scalded in the oven for at least 6 hours at a temperature of 90 degrees. The broth needs to be strained and cooled down.
Forecast and prevention of
There is no primary prevention of Dühring's disease, and it is important to strictly adhere to the non-gluten diet to prevent recurrence in patients.
Duration illness lasts long, periods of exacerbation alternate with remissions. In the course of treatment and the exclusion of gluten-containing products, it is possible to reduce the frequency of relapses to a minimum.