Dühring's dermatitis herpetiformis: symptoms, treatment

Dermatitis herpetiformis refers to chronic skin conditions characterized by rashes that resemble herpes, therefore, it is sometimes classified as Duhring's dermatitis (a famous scientist who studied this diseases).

The disease does not depend on the gender or age category of the patient, however, dermatitis most often occurs in men. In children, this form is much less common.

The reasons for the development of the disease

The exact reasons contributing to the development of the disease are unknown, but there are a number of factors that provoke Duhring's disease.

These include:

• a genetic predisposition in a child;
• disorders of the autoimmune system;
• malignant neoplasms;
• the causes of the disease may be hypersensitivity to cereal proteins and iodine;
• malfunctions of the endocrine system (especially during menopause and during pregnancy);
• helminthic invasions in a child;

• inflammatory processes in the digestive system;

• SARS, herpes, etc.

In addition, the risk of dermatitis herpetiformis increases after vaccinations, lymphogranulomatosis, and also as a result of stressful situations.

Symptoms

Dermatitis herpetiformis differs from other types of dermatitis in the polymorphism of rashes in the form of erythema, papules, watery blisters, which, after opening, merge into one inflamed focus.

With the disease, blisters are of different sizes: small (vesicles) and more than 2 cm in diameter. When they appear, the disease is characterized as bullous dermatitis. In case of infection, the fluid inside the blisters becomes cloudy. In this case, bullous dermatitis requires individual treatment.

The rash can be localized anywhere on the skin, excluding the palms, mucous membranes, and soles of the feet. Sometimes blisters appear on the oral mucosa, which open as quickly as possible and transform into erosion. As a rule, the rash appears symmetrically: on the extensor surfaces of the upper and lower extremities, buttocks, shoulder blades and shoulders.

In addition to a polymorphic rash, common to all dermatitis, symptoms are possible, expressed as unbearable itching, a burning sensation and tingling sensation in the affected area. The child may experience hyperthermia.

Possible insomnia, general weakness, disturbances in the gastrointestinal tract and disruptions in the endocrine system. Nikolsky's syndrome during herpetic dermatitis is not defined. Herpetic vesicular dermatitis is accompanied by periodic relapses and long-term remissions, which in some cases can reach one year.

Forms of the disease

Dühring's dermatitis herpetiformis is determined by several forms, depending on the predominance of a certain type of rash:

• Papular form - occurs during the predominance of papular rashes.
• Bullous - a rash, manifested with a predominance of bull.
• Vesicular - when a large area of ​​the body is covered with vesicles.
• Urtica-like - the rash resembles nettle burns.

• Sometimes there are atypical forms of the disease - strofuloid, trichophytoid and eczematoid.

In addition, when dermatitis occurs as a result of exposure to a malignant tumor, it is classified as para-oncological dermatosis.

Diagnostics

You can diagnose dermatitis herpetiformis by performing a test (iodine) of Jadasson, which involves the use of a compress with ointment. To do this, you need to take the same amount of petroleum jelly and potassium iodide. This mixture is applied to a healthy area of ​​the skin, keeping for 24 hours. When a reaction appears in the form of hyperemia, rashes, etc. after removing the bandage, the disease test is considered positive.

If Duhring's dermatitis herpetiformis is suspected, the patient may be referred for a blood test, as well as for a cytological examination of the contents of the blisters. With a positive result, an increased concentration of eosinophils is detected.

In addition, an additional examination is performed to exclude the presence of cancer.

The course of the disease in children

The herpetiform form of dermatitis at an early age is quite rare; 0.5% of children suffer from it, 10% of whom are infants. Both girls and boys get sick with the same frequency.

The symptoms of dermatitis are most often observed during the autumn and winter period. In a child, dermatitis develops acutely with a deterioration in the general condition. Lethargy, increased fatigue appear, sometimes hyperexcitation and hyperthermia are possible. The child is worried about severe itching, which gets worse at night. Infants are characterized by rashes in the form of larger blisters filled with serous contents, in which eosinophillia is determined up to 45%.

• The rashes are characterized by a tendency to combine into uneven figures in the form of rings, garlands and arcs, which closely resemble the outlines of a geographical map. Subsequently, the rash transforms into erosion, scales and scabs. After the rash disappears, pigmentation or depigmentation is noted, which disappears over time;

• most children have complications in the form of a secondary pyococcal infection. As a rule, there are obvious symptoms of polyadenitis. Differential diagnosis in children should be distinguished from epidermolysis bullosa, streptoderma bullosa, stromulus and bullous toxidermia, as well as from exudative erythema;
• when impetiginization occurs in children, treatment with antibacterial drugs (macrolides, Penicillin, Biseptin and Biseptol in dosages established for children) is carried out. To reduce the allergic effect on the child, a course use of antihistamines is prescribed (Tavegil, Claritin, Loratadin, Suprastin, etc.);
• with severe development, Dühring's dermatitis is recommended to be treated with a hormonal agent for a short time (no more than 10 days). The most commonly used Prednisolone (in TB. and solution for intramuscular injection) and hydrocortisone, etc. In addition, a gluten-free diet is prescribed for severe dermatitis. The introduction of gamma globulin in injections is effective (a course of 5-6 injections at least 2 times a week, 1-1.5 ml.).

As a local remedy, anti-inflammatory, antipruritic, antiseptic drugs in the form of ointments and creams are used, which lubricate the lesions after opening the blisters. Despite the fact that dermatitis of this form has a chronic course, in children, the disease can disappear on its own, after a few years, during puberty.

Treatment

In adult patients, the treatment of Duhring's disease is performed with drugs of the sulfone group (Diucifon, Dapsone, Autosulfone, Sulfapyridine, Diaphenylsulfone, etc.). If sulfone therapy is ineffective, corticosteroid treatment is prescribed.

To improve the immune forces, immunomodulators and vitamin complexes are used. Good folk immunomodulators are tincture of Eleutherococcus, Aralia and Leuzea. In addition, vitamin therapy with oral and intramuscular administration of vitamins B12, B2, C, PP, B1, B3, B and 6 retinol acetate shows good efficacy.

In addition, successful treatment of the disease involves adherence to a hypoallergenic diet that excludes foods such as seafood from the diet. They contain a large amount of iodine, which is undesirable in the development of herpetiform dermatitis.

External treatment involves the use of water procedures with a solution of potassium manganese and skin treatment with Fucocin, Dermatol ointment, Diamond green, etc.

Treatment of dermatitis is well complemented by folk remedies in the form of decoctions of calendula, licorice, mistletoe, juniper, sea buckthorn, etc.

Treatment with a homemade ointment shows good efficacy. In order to prepare this folk remedy, it is recommended to take 2 parts of internal fat, adding 1 part belladonna to it. Then the mixture is placed for 5-6 hours in an oven with a temperature of at least 90 ° C. After cooling down, the affected skin is treated with the prepared mixture.

It is important to note that any use of a drug and alternative therapy should be carried out under the supervision of a physician. This will allow you to achieve a positive result and long-term remission.