Dermatitis herpetiformis (DH) is a chronic skin disorder characterized by recurrent clusters of intensely itchy, symmetrically distributed, tense, erythematous papules and vesicles, usually on the extensor surfaces of the limbs, buttocks and shoulders. It is caused by an immune reaction to gluten, the main protein found in wheat, rye and barley.
The name of the condition comes from the characteristic grouping of lesions that resemble herpes simplex virus lesions. However, unlike herpes, dermatitis herpetiformis is not caused by a virus, but by an abnormal immune reaction to gluten.
People with DH often develop other autoimmune diseases, such as celiac disease and thyroid disease. The condition can be managed with a gluten-free diet, medications to control inflammation, and lifestyle changes.
DH can cause significant discomfort and can be disfiguring if left untreated. Symptoms typically include:
• Intense itching or burning
• Painful, raised bumps or patches of red, scaly, raised skin
• Blistering lesions that may ooze or crust
• Small bumps on the elbows, knees, scalp, back, and buttocks
• Thickened, leathery skin
The diagnosis of DH is based on a combination of medical history, physical examination, and a skin biopsy. Treatment options include a gluten-free diet, medications to reduce inflammation, and lifestyle changes.
A gluten-free diet is the most effective way to manage DH. This means avoiding wheat, rye, and barley, as well as any hidden sources of gluten, such as certain processed foods. In addition, other lifestyle changes, such as avoiding stress and getting enough rest, may help manage the symptoms of DH.
Finally, medications, such as topical steroids, may be prescribed to reduce inflammation and itching. In severe cases, drugs that suppress the immune system may be used.
In summary, dermatitis herpetiformis is a chronic skin disorder caused by an immune reaction to gluten. It is characterized by clusters of intensely itchy, symmetrically distributed, tense, erythematous papules and vesicles. It can be managed with a gluten-free diet, medications to control inflammation, and lifestyle changes.