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Dermatitis herpetiformis

Contents of this page:

Illustrations

Dermatitis, herpetiformis - close-up of lesion
Dermatitis, herpetiformis - close-up of lesion
Dermatitis, herpetiformis on the knee
Dermatitis, herpetiformis on the knee
Dermatitis, herpetiformis on the arm and legs
Dermatitis, herpetiformis on the arm and legs
Dermatitis, herpetiformis on the thumb
Dermatitis, herpetiformis on the thumb
Dermatitis, herpetiformis on the hand
Dermatitis, herpetiformis on the hand
Dermatitis, herpetiformis on the forearm
Dermatitis, herpetiformis on the forearm

Alternative Names    Return to top

Duhring's disease

Definition    Return to top

Dermatitis herpetiformis is an extremely itchy rash made of bumps and blisters. The rash is chronic, which means it continues over a long period of time.

Causes    Return to top

Dermatitis herpetiformis usually begins in people age 20 and older, although children may sometimes be affected. It is seen in both men and women.

The cause is unknown. However, dermatitis herpetiformis is frequently linked to gluten sensitivity (celiac sprue disease) in the small bowel.

Symptoms    Return to top

Dermatitis herpetiformis is usually extremely itchy. The bumps or blisters usually appear on the elbows, knees, back, and buttocks. In most cases, the rash is the same size and shape on both sides. Symptoms of dermatitis herpetiformis tend to come and go.

Exams and Tests    Return to top

A skin biopsy and direct immunofluorescence test of the skin are performed in most cases. Your doctor may also recommend a biopsy of the intestines.

Treatment    Return to top

Dapsone, an antibiotic, may help most patients.

A strict gluten-free diet will also be recommended to help control the disease. Sticking to this diet may remove the need for medications and prevent later complications.

Outlook (Prognosis)    Return to top

The disease may be well controlled with treatment. Without treatment, there may be a significant risk of intestinal cancer.

Possible Complications    Return to top

Thyroid disease may be found in many patients with dermatitis herpetiformis. Patients are also more likely to develop certain cancers of the intestines.

When to Contact a Medical Professional    Return to top

Call your health care provider if you have a rash that continues despite home treatment.

Prevention    Return to top

There is no known prevention of this disease. People with this condition may be able to prevent complications by avoiding foods that contain gluten.

References    Return to top

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004.

McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. St. Louis, Mo: WB Saunders; 2006.

Update Date: 4/15/2009

Updated by: Jonathan Kantor, MD, North Florida Dermatology Associates, Jacksonville, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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