Dermatitis herpetiformis: symptoms, causes, treatment, etc.

Definition

What is dermatitis herpetiformis?

Dermatitis herpetiformis is an autoimmune disease that causes skin inflammation. This disease causes a red, blister-like burn rash, similar to a lesion or wound caused by a herpes zoster virus infection.

The rash that appears usually feels so itchy that treatment is needed to resolve it. Treatment is generally a combination of lifestyle changes and medication to reduce the severity of symptoms.

Compared to other types of dermatitis, dermatitis herpetiformis is actually quite rare. The symptom collection is mostly experienced by adults aged 30-40 years, with the number of male sufferers being higher than female.

This disease is also more common in people who have celiac disease. According to the Celiac Disease Foundation, about 10-15% of people affected by this type of dermatitis also have celiac disease.

Although it can't be prevented, you can reduce your risk in several ways. Recognizing the signs will also aid in the diagnosis so that the disease can be treated promptly.

Symptoms

What are the signs and symptoms of dermatitis herpetiformis?

The appearance of this type of dermatitis is characterized by a sharp burning sensation on the surface of the skin. After that, then the reddish spots begin to appear one by one.

The common symptoms of dermatitis herpetiformis are as follows.

• Accumulated reddish spots.
• The blister is similar to a burn (lesion).
• The wound looks like an insect bite.
• Unbearable itching sensation.
• Hot feeling like burning.

Red spots and blisters can appear on various parts of the body, from the head and face, forearms, knees, to the back and buttocks. However, symptoms usually do not appear immediately on either side of the body.

The blister will usually crust up and become ulcerated within 1-2 weeks. The peeled area will then leave a purple mark, which is followed by the appearance of a collection of new reddish spots on other parts of the body.

Some people with dermatitis herpetiformis who have celiac disease may also have other symptoms. One of them is permanent defects in the enamel layer of the teeth.

When should I see a doctor?

Dermatitis herpetiformis can be treated if the symptoms are still mild. If not treated properly, symptoms can actually get worse due to constant scratching or injury during physical activity.

When this happens, the skin will be more susceptible to bacterial, viral, and fungal infections. The skin also loses its protective layer so it is more prone to irritation from exposure to various substances from the environment.

Even in some cases, complications of dermatitis can occur in the form of herpes virus infection. Therefore, if you experience some of the symptoms mentioned above, consult a doctor immediately.

Cause

What causes dermatitis herpetiformis?

Dermatitis herpetiformis is caused by a combination of internal and external factors. On internal factors, there are two genes passed down from parents that are thought to be associated with the appearance of dermatitis herpetiformis and celiac disease.

Inheritance of these genes occurs in children born with autoimmune disorders. This disease causes the release of large amounts of immunoglobulin A (IgA) antibodies. IgA then builds up in blood vessels in the skin.

Meanwhile, external factors that play a role are gluten consumption. Gluten is a type of protein found in starchy foods. People with celiac disease cannot consume gluten because it can damage the small intestinal tissue.

Consumption of gluten is thought to contribute to the buildup of IgA in the blood and trigger an overreaction of the immune system. This then causes blockages in the skin tissue and leads to the formation of blisters on the skin.

Several previous studies have also shown that by reducing gluten intake, the symptoms of dermatitis herpetiformis can be reduced. From this, experts conclude that gluten consumption is associated with the appearance of dermatitis herpetiformis.

Who is at risk for dermatitis herpetiformis?

There are various factors that can increase a person's risk of developing dermatitis herpetiformis. However, this disease tends to occur in people who have family members with the following medical history.

• Celiac disease or gluten intolerance.
• European descent.
• Type 1 diabetes.
• Down syndrome or Turner syndrome.
• Thyroid gland disease.
• Sjogren's Syndrome.
• Colitis.

Even if you do not have the factors above, it does not mean you are free from the risk of this disease. You can detect dermatitis herpetiformis as early as possible by recognizing the symptoms.

Diagnosis

How do doctors diagnose this disease?

In the early stages of diagnosis, your doctor will ask you about any symptoms you have experienced. The doctor will also check your medical history and whether you have previously had other skin diseases or not.

The symptoms of dermatitis herpetiformis can be mistakenly recognized as atopic dermatitis (eczema), contact dermatitis, or psoriasis. Therefore, usually the doctor will ask you to undergo several tests.

The test used to diagnose dermatitis herpetiformis is.

• Skin biopsy. Examination of skin samples under a microscope to detect the presence of IgA in skin tissue.
• Blood test. Examination of a blood sample to identify the presence of IgA antibodies in the blood.
• Skin patch test. A patch test is done to find out if there are certain types of allergens that cause inflammation of the skin.

The process of diagnosis in people with celiac disease may also be accompanied by a biopsy of the intestine or digestive tract. This aims to see the damage that occurs in the intestine.

Medicine and medication

What are the treatment options available?

Treatment cannot completely cure dermatitis herpetiformis. Even so, this step is useful for relieving symptoms, preventing recurrence, and preventing the blisters from getting worse.

The treatment process depends on the severity of the disease. Treatment may involve taking medications, using moisturizers and ointments, a gluten diet, and taking a warm bath.

Your doctor may prescribe dapsone to get rid of the itching quickly, but this medicine should only be taken temporarily. Medicines usually react within 48 - 72 hours after consumption.

Patients who cannot take dapsone due to certain medical conditions can take alternatives in the form of sulfapyridine or sulfasalazine. However, they may not be as effective as dapsone.

In addition, corticosteroid creams or ointments, calamine lotions, and antihistamines can also reduce inflammation and control the symptoms of a red, blistering rash. Make sure you have discussed with your doctor before using any medication.

Ultimately, the best way to treat dermatitis herpetiformis is to avoid all foods containing gluten. This method has been shown to be effective in repairing skin damaged by blisters.

Home remedies

What are some lifestyle changes to support healing?

Below are lifestyle improvements and home remedies to help relieve the symptoms of dermatitis herpetiformis.

• Avoid foods that contain gluten.
• Avoid activities that make the body sweat a lot.
• Bathing regularly to reduce the risk of infection.
• Wash clothes, towels and sheets regularly.
• Perform routine checks as recommended by the doctor.
• Using drugs prescribed by a doctor.
• Call a doctor if the blisters get worse or new sores appear during treatment.

Dermatitis herpetiformis is an inflammation of the skin associated with celiac disease. You can treat the symptoms with medication, but the best way to prevent it is to avoid foods containing gluten.