Dermatitis herpetiformis
| Dermatitis herpetiformis | |
|---|---|
 |
|
| Dermatitis herpetiformis characteristic rash | |
| Classification and external resources | |
| Specialty | Dermatology |
| ICD-10 | L12.2, L13 |
| ICD-9-CM | 694.0 |
| DiseasesDB | 3597 |
| MedlinePlus | 001480 |
| eMedicine | derm/95 |
| MeSH | D003874 |
Dermatitis herpetiformis (DH), or Duhring's disease, is a chronic blistering skin condition, characterised by blisters filled with a watery fluid. Despite its name, DH is neither related to nor caused by herpes virus: the name means that it is a skin inflammation having an appearance similar to herpes.
DH was first described by Louis Adolphus Duhring in 1884. A connection between DH and coeliac disease was recognised in 1967, although the exact causal mechanism is not known. DH is a specific manifestation of coeliac disease.
The age of onset is usually about 15-40, but DH can also affect children and the elderly. Men and women are equally affected. Estimates of DH prevalence vary from 1 in 400 to 1 in 10000. It is most common in patients of northern European/northern Indian ancestry, and is associated with the HLA-DQ2 haplotype along with coeliac disease and gluten sensitivity.
Dermatitis herpetiformis is characterized by intensely itchy, chronic papulovesicular eruptions, usually distributed symmetrically on extensor surfaces (buttocks, back of neck, scalp, elbows, knees, back, hairline, groin, or face). The blisters vary in size from very small up to 1 cm across.
The condition is extremely itchy, and the desire to scratch can be overwhelming. This sometimes causes the sufferer to scratch the blisters off before they are examined by a physician. Intense itching or burning sensations are sometimes felt before the blisters appear in a particular area.
Untreated, the severity of DH can vary significantly over time, in response to the amount of gluten ingested.
Dermatitis herpetiformis symptoms typically first appear in the early years of adulthood between 20 and 30 years of age.
Although the first signs and symptoms of dermatitis herpetiformis are intense itching and burning, the first visible signs are the small papules or vesicles that usually look like red bumps or blisters. The rash rarely occurs on other mucous membranes, excepting the mouth or lips. The symptoms range in severity from mild to serious, but they are likely to disappear if gluten ingestion is avoided and appropriate treatment is administered.
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Wikipedia