Dermatitis herpetiformis is a chronic blistering rash that often occurs in people with celiac disease. Dermatitis herpetiformis generally causes complaints in the form of a rash accompanied by itching or a burning sensation on the skin.
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| Dermatitis Herpetiformis, Causes, Diagnosis, Treatment, Prevention, Complications |
Dermatitis herpetiformis, also known as Dühring's disease, is a rare disease. This condition occurs in 10–25% of people with celiac disease. Symptoms of dermatitis herpetiformis usually subside when the sufferer is on a gluten-free diet.
Symptoms of Dermatitis Herpetiformis
Dermatitis herpetiformis generally causes complaints in the form of blisters on several parts of the body, such as the elbows, knees, lower back, scalp, back of the neck, shoulders and buttocks. In rare cases, a rash can also appear in the mouth without being accompanied by other symptoms.
The rash experienced by sufferers of dermatitis herpetiformis usually has the following characteristics:
- Very itchy
- Accompanied by a burning sensation
- Resembling a burn filled with fluid, with scratch marks around it
- Formed as a collection of reddish spots in one area
- Have similar size and shape on both sides of the body
Apart from the skin, dermatitis herpetiformis can also cause dental and digestive problems. Dental problems that can be experienced include damage to the outer layer (enamel) of teeth, cavities, and tooth discoloration.
In addition to problems with the teeth, dermatitis herpetiformis can also cause digestive problems in the form of:
- Diarrhea
- Constipation (constipation)
- Stomach ache
- Bloated
Causes of Dermatitis Herpetiformis
Dermatitis herpetiformis is caused by an autoimmune disease, which is a condition in which the body's immune system attacks skin cells and tissues.
In dermatitis herpetiformis or gluten rash, an autoimmune reaction can cause a rash when the sufferer eats foods that contain gluten. Gluten is a type of protein contained in wheat products, such as noodles, pasta, cereals, biscuits, bread and other wheat-based foods.
The appearance of dermatitis herpetiformis is also thought to be related to genetic factors, namely due to mutations in the HLA-DQ2 and HLA-DQ8 genes.
A person's risk of developing dermatitis herpetiformis increases by more than 5% if their family also suffers from this condition. In addition, a person is also more at risk of developing dermatitis herpetiformis if they suffer from other autoimmune diseases, such as:
- Autoimmune thyroid disease, such as Hashimoto's disease
- Sjögren's syndrome
- Type 1 diabetes
- Lupus
Diagnosis of Dermatitis Herpetiformis
Check with your doctor if you experience the symptoms of dermatitis herpetiformis as mentioned above, especially if they get worse. The rash of dermatitis herpetiformis is similar to the symptoms of other skin diseases. Therefore, an examination needs to be done to determine the type of treatment to be given.
To diagnose dermatitis herpetiformis, the doctor will first ask the patient about the symptoms they are experiencing and their medical history. The doctor will also ask if skin rashes appear when eating foods that contain gluten.
Next, the doctor will carry out a physical examination by looking directly at the patient's skin condition. If needed, the doctor will carry out the following examinations:
- Blood test, to detect antibodies to gluten whose levels are elevated in people with celiac disease
- Genetic tests, to check for gene changes which also usually occur in people with celiac disease
- Skin biopsy, to detect immunoglobulin A (IgA) which usually collects in dermatitis herpetiformis rashes
- Allergy test, to diagnose whether the rash is caused by dermatitis herpetiformis or due to another disease, such as contact dermatitis
Treatment of Dermatitis Herpetiformis
Treatment for dermatitis herpetiformis will be adjusted to the symptoms that appear and their severity. The treatment method given by the doctor can be in the form of a gluten-free diet or drugs. Here is the explanation:
Gluten free diet
The doctor, assisted by a nutritionist, will suggest a gluten-free food menu that the patient must consume for several months to 2 years. Some of the benefits that will be obtained from this gluten-free diet are:
- Reducing the use of symptom relievers
- Reducing the risk of other autoimmune diseases
- Reducing the risk of lymphoma tumors in the intestine
- Relieves intestinal sensitivity to gluten
- Improve nutritional intake
Drugs
The doctor will give you oral antibiotics, namely dapsone. This drug works to relieve the symptoms of a rash that appears in about 3 days.
It should be noted that dapsone is an antibiotic that can cause some dangerous side effects, such as anemia. Therefore, this drug should only be consumed on the advice and evaluation of a doctor.
If the patient cannot take dapsone due to certain conditions, the doctor will replace it with sulfapyridine or sulfasalazine. To overcome the itching felt by the patient, the doctor can also give corticosteroid cream drugs.
Doctors will also advise patients to avoid consuming iodized salt and several types of non-steroidal anti-inflammatory drugs (NSAIDs). This is because iodine and NSAIDs can trigger a recurrence of dermatitis herpetiformis.
Dermatitis herpetiformis complications
Dermatitis herpetiformis that is not treated properly has the risk of causing various complications, such as:
- Anemia
- Osteoporosis
- Deficiency (deficiency) of vitamins
- Certain bowel cancers, such as small bowel lymphoma
- Worsening of existing autoimmune disease
Prevention of Dermatitis Herpetiformis
Not yet known how to prevent dermatitis herpetiformis. However, for celiac sufferers, dermatitis herpetiformis can be prevented by adopting a gluten-free diet.
One way to adopt a gluten-free diet is to replace wheat flour with wheat-free flour, such as corn flour or rice flour. In addition, make sure to always carefully read food and sauce packaging labels to avoid gluten contained in them.
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