Dermatitis Herpetiformis

Dermatitis Herpetiformis is a rare and chronic skin disorder characterized by extremely itchy and almost intolerable rashes made of bumps and blisters that normally occur on the elbows, knees, shoulders, back, and buttocks. It is believed to be related to coeliac disease, a disorder of the small intestine. Dermatitis Herpetiformis is also referred to as Durhing’s disease.

The predominant symptoms of Dermatitis Herpetiformis include intense burning, stinging, and itching sensations in affected areas. Diagnosis is mainly through physical evidence and analysis of skin biopsies. The ailment most commonly affects young adults, particularly males, aged 20 and higher. Estimates suggest that the disease currently affects about 11.2 out of every 100,000 people in the United States and about 10 out of every 100,000 people internationally. The disease is more common in young males of European descent (particularly from Scandinavian countries) than those of other ethnic backgrounds.

The exact cause of Dermatitis Herpetiformis is unknown but it is believed to be related to an allergy to gluten, a protein found in wheat and other grains. When gluten combines with IgA (an antibody produced by the intestines), the combination enters the blood stream and begins circulating. This combination then causes small blood vessels in the skin to get clogged up, attracts while blood cells, and secretes chemicals which then cause rashes to form.

Treatment

The most effective means of treating Dermatitis Herpetiformis is with a drug called Dapsone. Dapsone can alleviate symptoms within days but it does have side effects like haemolytic anaemia, a blood disorder. Therefore, its usage should be monitored closely and it should only be taken under the supervision of a qualified physician. For those intolerant or allergic to Dapsone, topical and systemic steroids and Sulfapyridine are also available options. A gluten free diet is also highly recommended and this reduces dependence on Dapsone and the risk of developing other conditions.

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