Dühring's dermatitis herpetiformis: invisible causes and severe consequences. Mysterious Dühring's disease: treatment and prevention Dühring's disease treatment

There are many different skin conditions that affect people around the world. Some of them are temporary and can go away on their own, but there are chronic diseases that often recur and cause a lot of inconvenience, causing severe discomfort. One of these pathologies is dermatitis herpetiformis.

Description of the disease

Dühring's dermatitis herpetiformis is a type of chronic skin disease in which erythematous rashes, blisters, vesicles and papules form on the skin. The affected areas are very itchy. Relapses occur frequently and cause a lot of inconvenience to patients. The disease got its name because the rash with Dühring's dermatitis is very similar in appearance to skin rashes with herpes. Another name is pemphigoid herpes.

Erythematous rashes can appear in many different diseases. They are reddish or pinkish spots with visible capillaries, which can merge into a single spot if there are a lot of them. Vesicles are small bubbles of fluid on the surface of the skin. Papules are special nodules that look like small pimples and do not have an internal cavity.

Dermatitis herpetiformis can affect large areas of skin

The disease is most often detected between the ages of 20 and 40 years. Dühring's dermatitis mainly affects men; it occurs in them twice as often as in women. Sometimes this disease accompanies patients with oncological tumors, which makes it one of the signs of the formation of cancer, and is a type of para-oncological dermatosis.

The acute stage of dermatitis herpetiformis can be followed by fairly long periods of remission, which sometimes last several years.

Forms of the disease

Depending on which type of rash manifests itself most, several forms of Dühring's dermatitis herpetiformis are distinguished:

The last three forms are atypical and may be similar to others dermatological diseases.

Causes and development factors

At the moment, the causes of dermatitis herpetiformis are not yet fully understood. Scientists put forward several hypotheses about the factors in the formation of this disease:

individual intolerance to gluten protein, which is found in large quantities in cereals;
hereditary predisposition also plays a role in the occurrence of this type of dermatitis. If parents suffered from the disease, then their children's chances of getting sick double. Which gene is responsible for this pathology is not yet known at this time;
autoimmune disorders in the body, which are indicated by a special antigen IgA, found in patients in the basement membrane between the dermis and epidermis;
sensitivity to iodine and iodine-containing products;
helminth infection (ascariasis);
various types of gastrointestinal diseases (gastritis, ulcers);
viral lesions of the body (ARVI, herpes, etc.);
hormonal changes during pregnancy and menopause;
the body's reaction to the vaccination;
nervous and physical exhaustion of the body;
excessive insolation (frequent exposure to the sun).

Video about gluten intolerance in Elena Malysheva’s program “Live Healthy!”

Symptoms

The first signs of dermatitis herpetiformis are itching, burning and tingling. Some patients develop paresthesia, in which sensitivity occurs and some areas of the skin become numb. After about ten hours, special rashes begin to appear in the form of erythematous spots and various blisters filled with liquid. The bubbles are small, deeply located and very elastic due to their serous contents. Most often, the onset of the disease is acute, and all symptoms develop very quickly.

Blisters with serous contents very often burst when combed and leave behind erosions

Sometimes, next to the inflammation, small bruises appear in the form of small subcutaneous bruises (petechiae and ecchymosis), they are about 3 mm in size. Over time, after combing, erosions can form, which are subsequently covered with yellowish crusts. After healing, lighter areas remain on the skin or, conversely, pigmented areas. If the wounds were deep, then scars may form in their place.

Erythematous spots have a clearly defined border and a round or oval shape. They can grow, merge with each other and form large spots covered with wounds, crusts and blisters. The latter can be either very small or reach a size of about two centimeters, turning into bullous blisters. They're filled clear liquid, which may become cloudy if infection occurs.

Typically, rashes are found on the following areas of the body:

extensor surface of the limbs;
gluteal region;
sacrum;
scalp;
face;
shoulder blades;
shoulders;
small of the back.

In general, all areas of the body can be affected except the soles of the feet and palms. The mucous membrane is rarely affected, but some patients may develop blisters in the mouth that quickly develop into erosive areas that take a long time to heal.

Vesicles and blisters are usually yellowish in color due to serous contents

Diagnosis and differential diagnosis

There are several ways to diagnose dermatitis herpetiformis. The doctor may prescribe the following procedures:

The Jadassohn iodine test consists of studying the patient’s body’s response to an irritant. The doctor selects an area of skin not affected by the disease and applies a lotion soaked in 50% potassium iodide on it. After a day, the compress is removed, and if redness, blisters or papules are found underneath it, this indicates Dühring's dermatitis. If there is no reaction, the procedure is repeated, but an already healed area of skin is used, on which pigmentation remains after the rash. In rare cases, iodine may be prescribed orally, but this can lead to serious consequences.
General blood test and cytological analysis contents of blisters. In case of dermatitis herpetiformis in a patient, the results obtained will significantly overestimate the content of eosinophils, special leukocytes.
Histological examination of the affected areas of the skin. This disease is characterized by the discovery of special cavities under the epidermis in which eosinophils, neutrophils and their breakdown products accumulate.
The direct immunofluorescence reaction is prescribed to detect immunoglobulin A (IgA) on the dermal papillae.

Differential diagnosis is carried out to exclude Lever's disease (bullous pemphigoid), pemphigus vulgaris, herpetic vesicular dermatitis, bullous toxiderma, benign Hailey-Hailey pemphigus, subcorneal pustulosis, exudative erythema.

Since Dühring’s dermatitis can be a para-oncological disease, patients may be prescribed additional examination of internal organs using ultrasound, X-ray, magnetic resonance or computed tomography.

Treatment of the disease

When the first symptoms appear, you should consult a dermatologist. After collecting all the tests, the doctor will prescribe individual treatment, which will depend on the patient’s medical history and concomitant diseases.

Drug therapy

There are several types of medications that are prescribed for dermatitis herpetitis:

Antileprosy drugs included in the sulfonamide group. They disrupt the process of folate synthesis in microbial cells, have an antibacterial effect and suppress the development of Dühring's dermatitis. These are quite serious medications that can cause many side effects. These include Diaphenylsulfone, Diucifon, Dapsone, Sulfasalazine, Solusulfone and some others.
Corticosteroids are prescribed if sulfone therapy (Prednisolone, Dexamethasone, etc.) is ineffective.
Antihistamines are necessary to eliminate itching and swelling (Zodak, Loratadine, Cetirizine).

For local treatment a solution of potassium permanganate, corticosteroid ointments, and treatment of erosions with brilliant green and fucorcin are used.

In the bullous form, the blisters are opened. The procedure is performed with extreme caution so as not to damage the bottom of the bladder. Otherwise, erosions will appear that require surgical treatment.

Medications - photo gallery

Zodak is a 2nd generation antiallergic agent with a prolonged effect Prednisolone is a synthetic glucocorticoid drug. Sulfasalazine is a drug with antimicrobial and anti-inflammatory properties.

Diet and nutrition

During treatment of Dühring's dermatitis, the patient should exclude from the diet all kinds of foods that contain iodine. It can be:

seafood;
seaweed;
some types of fish;
feijoa;
dried apricots;
chicken yolks;
potato;
iodized salt.

You should also not eat gluten-containing grains and all dishes prepared from them:

wheat;
barley;
oats;
rye.

Iodine is found in large quantities in sea fish

In addition to the above products, you should exclude:

kvass, beer and beer drinks;
coffee substitutes;
chocolate, candy, ice cream;
breaded semi-finished products;
smoked and pickled products;
sausages.

Video about a gluten-free diet from the Union of Pediatricians of Russia

Folk remedies

Folk remedies can only be used after consulting a doctor, since even herbal preparations, despite seeming harmless, can cause complications.

For Dühring's dermatitis herpetiformis, herbs that have anti-inflammatory and antihistamine effects are suitable. These include calendula, juniper, licorice, and sea buckthorn.

Calendula has anti-inflammatory, antiseptic, healing properties

To strengthen the immune system, pharmacy tinctures of eleutherococcus and ginseng are suitable.

Herbal tincture

The use of this recipe helps eliminate germs and bacteria, dry wounds and relieve inflammation.

Take one teaspoon each of juniper, tansy, nettle, calendula and yarrow.
Pour the resulting mixture with 0.5 liters of vodka.
Place the liquid in a glass jar and place in a dark place for 10–15 days.
Strain the tincture.
Wipe the affected areas of the skin once a day.

The course of procedures is individual and lasts, on average, about 5–10 days.

Physiotherapy

As a rule, physiotherapeutic treatment is not prescribed for this pathology. Radiotherapy may be used if medication is ineffective.

Treatment prognosis and possible complications

It is extremely difficult to cure dermatitis herpetiformis; it usually occurs in chronic form. The disease often recurs, especially if the diet and doctor’s recommendations are not followed. The main complication that can occur is secondary infection due to bacteria entering open wounds.

Prevention

There are no specific preventive measures to prevent dermatitis herpetiformis. If the patient is aware of his body's sensitivity to gluten and iodine, then he should avoid foods that contain these substances throughout his life to prevent relapses of the disease.

It is also important to establish a sleep schedule, get more rest, avoid overwork and stressful situations. It is worth monitoring your immunity and strengthening it in every possible way with the help of hardening or special medications.

Among other things, it is necessary to normalize the functioning of the gastrointestinal tract, improve the condition of the intestinal microflora and eat less junk food.

Features of the disease in children

At a younger age, treatment is sometimes not required, since very often the disease can go away on its own. The symptoms and causes of the formation of Dühring's dermatitis herpetiformis in children are the same as in adults. The treatment prescribed is similar, only in smaller dosages. It is imperative to follow a diet, and if the disease appears in an infant, then the mother needs to monitor her diet. She should exclude iodine-containing foods and gluten.

In most children, Dühring's disease develops after infectious diseases.

Almost all dermatitis, as independent diseases, is characterized by a chronic relapsing course against the background of immune failure or genetic predisposition. Dühring's dermatitis herpetiformis (named after the 19th century doctor who first described it) was no exception.

Of the 10 cases, 8 are males aged 20 to 50 years. In the presence of other similar pathologies of the dermis, the risk of the disease increases sharply (by 50% for men, by 5% for women).

Herpetic vesicular dermatitis (second name) in its manifestations resembles many others skin diseases, and always – herpes rashes that occur when herpes viruses type 1 or 2 are infected/intensified in the body.

There is even a theory that a disease that is so similar to herpes may be its complication, a transition viral infection into a subacute chronic nature. But it is more likely that the disease is autoimmune in nature. The latter is supported by the fact that Dühring's dermatitis can occur against the background of autoimmune diseases of the large intestine.

According to the most obvious criterion, when examining a patient, a dermatologist divides the disease into:

acute (primary);
exacerbation;
chronic subacute;
chronic in remission.

According to the characteristics of the main symptoms, the following are distinguished:

herpetiform (serous vesicles have a diameter of more than 1.5-2 cm);
herpetiform vesicular (vesicle size up to 1 cm).

Sometimes senile dermatitis herpetiformis is separately identified, which occurs after 50-55 years due to age-related hormonal changes in the body without any particular visible reasons.

The main feature of this disease is that, as a rule, when it occurs and develops, the specific cause of its occurrence is not determined. There are almost always several of them, many of them cannot be immediately identified.

Causes

There are three main, background reasons for the development of dermatitis herpetiformis:

Heredity - if both parents have similar pathologies, the risk of developing the disease is at least 65%, if one parent is at least 30%, if both parents are healthy, the risk of getting sick is no more than 15%.
The reasons for the development of this skin disease Immunological disruptions and some infections may occur, which themselves are the cause or consequence of such a failure.
Disruption of the functioning of the gastrointestinal tract, and specifically the absorption processes in the large intestine (primarily, this concerns the mechanisms of gluten absorption).

Within these 3 factors, all others operate:

autoimmune pathologies, especially those related to the gastrointestinal tract (Crohn's disease, UC);
celiac disease - many people mistakenly consider it an allergy to gluten (one of the proteins in cereals), but the problem here is its poor digestion in the small intestine, which causes an immune attack on the villi of the mucous membrane small intestine. It often happens that herpetic dermatitis is a symptom disease indicating problems with the absorption of gluten;
long-term endocrine disorders any etiology (chemotherapy, drug therapy, diseases of the endocrine glands, age-related changes);
allergies to medications and products containing a large number of iodine;
herpes viruses various types and other viruses;
various toxic poisonings;
life under the influence of numerous negative factors: poor ecology, sharply continental climate, unfavorable social conditions, poor nutrition, constant stress, lack of sleep, smoking, alcoholism.

The characteristics of the disease do not yet allow us to determine any unambiguous factor. Firstly, most likely, a complex of the listed conditions leads to pathology, and secondly, one or another reason will predominate in different patients.

Symptoms

Dermatitis herpetiformis symptoms are partially similar to several other skin pathologies:

herpes dermatitis (when the clear cause of damage to the dermis is the herpes virus);
dyshidrotic eczema;
other types of dermatitis (contact, toxicoderma).

Descriptions of symptoms may vary from patient to patient. Despite the fact that the pathology is much more common in adults, there are also childhood cases of this type of dermatitis.

The most complete clinical picture in the acute period is as follows:

expressed itchy skin, hyperemia, swelling;
after a couple of days, transparent serous vesicles (vesicles) appear at the site of itching and redness;
serous formations burst on their own or are damaged by the patient during the scratching process, leaving behind long-healing erosions.

This picture is observed in an exacerbation in any sick person, i.e. This is a mandatory set of symptoms.

The most characteristic Dühring's dermatitis is serous blisters.

Similar formations are also always observed during an attack of the herpes virus and in dyshidrotic eczema.

There is also an additional set of symptoms, the presence of which depends on the severity of the disease, individual characteristics body.

Namely:

formation of erythema multiforme on the affected areas;
the appearance of coin-shaped eczema;
Petechiae may occur - small subcutaneous hemorrhages;
the formation of blisters and papules located quite deeply;
systemic symptoms can be expressed by an increase in body temperature to subfebrile levels, general weakness, sleep disturbances and appetite disturbances.

Dermatitis herpetiformis, unlike other dermatitis, is characterized by symptomatic polymorphism. Those. Symptoms may occur at the same time different stages: itching, blisters, erosions, erythema, temperature.

Scratching can cause infection in wounds and ulcers. Most often, this is St. aureus ( Staphylococcus aureus) or a type of streptococcus.

Localization of rashes

Herpetic vesicular dermatitis in 85% of all cases affects the back - the area of the shoulder blades, as well as the shoulders and lower back.
Skin rashes are recorded much less frequently with reverse side– on the stomach, neck, chest.
Elements of the rash in some patients were noted on the face, thighs, knees, legs, shoulders, and forearms. But never on the hands or feet.

The size of the affected skin areas can vary significantly:

in area - small “islands” or vast areas of tens of square centimeters;
according to the picture - uniform points along the entire back or complete damage to one area, for example, the lower back.

It is characteristic that especially many blistering papules and vesicles form, as a rule, in the area of the shoulder blades.

Unpleasant signs

The pathology in question is not so much dangerous for physical survival (although in some cases, according to some signs, it can be dangerous), but rather causes discomfort in patients:

itching - anywhere and everywhere (at home, at work, on the street, on vacation, in bed);
burning sensation that accompanies the resolution of serous vesicles;
when the blisters open, the skin takes on an equally repulsive appearance - weeping, fresh sores, scabs, pigmentation;
low-grade fever, general weakness, weakness, sleep problems;
in the section on treatment we will talk about diet, and food restrictions, as we know, can greatly torment a person.

During severe exacerbations It becomes extremely difficult for the patient to lead a normal life.

Diagnostics

Diagnostics in dermatology according to the basic scheme is similar to other branches of medicine:

clinical examination, study of symptoms;
general, biochemical and special blood tests;
allergy tests to identify characteristic irritants;
microbiological examination of collected biomaterials and study of cell morphology.

Herpetic dermatitis is quite accurately diagnosed at the stage of initial consultation with a dermatologist. This is especially easy to do during an exacerbation period, as well as against the background of related diseases.

Diagnosis of dermatitis herpetiformis is represented by the following tests:

One of the key indicators for this disease is the Jadassohn iodine test.
– Potassium iodide is used as an indicator.
– First, 50% potassium iodide ointment is left under a bandage on healthy skin for 24 hours.
– If a reactive reaction of the dermis does not occur, then similarly, after two days, the ointment is applied to the area skin, which was previously subject to immune attack, but has now healed.
– If the test here turns out to be negative, then again after two days at least 2 tbsp is prescribed. spoons of 3% or 5% potassium iodide solution orally.
– A completely negative sample will be considered if internal reception there was no response.
– The positivity of the Jadasson test in the presence of characteristic symptoms almost guarantees the diagnosis of “Dühring’s dermatitis.”
General and biochemical blood test.
– With this disease, eosinophilia and an increased content of leukocytes are noted.
– Biochemistry may be normal, but sometimes low albumin is noted.
Microbiological examination of skin scrapings from the affected area.
– This operation is performed mainly to determine whether a secondary fungal infection has occurred.
Along with the Jadasson test, they carry out histological examination bubble contents.
Immunochemical analysis allows you to dismiss/confirm herpes virus types 1 and 2.

For older people, diagnostic methods are supplemented by consultation with an oncologist, ultrasound of internal organs and thyroid gland, tomography. The fact is that in old age, the symptoms of dermatitis may indicate oncological processes.

Therapeutic measures

Treatment of Dühring's dermatitis is multi-stage and is determined depending on individual circumstances.

Main treatments include:

anti-inflammatory therapy;
antiallergic therapy;
diet (if skin problems come from intestinal problems, especially with celiac disease);
therapy that optimizes immunity.

Traditional medicine and lifestyle adjustments play a significant role in patient therapy.

Drugs for treatment

In severe, acute conditions, it is necessary to tone down inflammatory process in organism.

When the immune attack is generalized, a short systemic course of hormones is prescribed:

Prednisolone droppers or tablets;
intramuscular injections of Dexamethasone.

Apply to the affected areas hormonal ointments:

Akriderm, Triderm (a.v. – Betamethasone);
Lorinden A (a.v. – Flumethasone);
Hydrocortisone (a.v. – Cortisol).

If it happens differently in adults, then herpetic dermatitis in children will definitely require the use of antiallergic antihistamines:

Suprastin;
Loratadine;
Erius (Desloratadine), etc.

Drugs of the sulfone group (Dapsone, Sulfetron) actively suppress almost all classes of pathogenic microflora, preventing the development of secondary infection and sepsis. Diucifon not only blocks the development of pathogenic microflora, but also stimulates trophism and regeneration of the skin.

Finally, many patients successfully maintain mild and moderate forms of Dühring’s dermatitis in a state of remission thanks to such drugs, proven by Soviet medicine as:

Fukortsin;
brilliant green;
methylene blue;
boric acid;
zinc paste.

The mechanism of action of these substances is still not really clear, but it is undeniable that they create a healing and protective film on the affected areas of the skin.

Traditional methods

Traditional medicine has an extensive “arsenal” of remedies that can serve as powerful complementary therapy. And during the period of remission - high-quality basic.

Treat pathology folk recipes permissible after consultation with your doctor.

There are many options here, here are just a few:

Pork lard plus dried belladonna herb (ratio 2:1).
– Melt the lard and add the herb, keep the resulting mixture in the oven at a temperature of at least 90 degrees for at least 5 hours, cool, strain – the ointment is ready.
Herbal collection.
– Calendula, nettle, juniper, yarrow, tansy, a tablespoon of each herb, pour 0.5 liters of vodka, leave for 10 days in a dry and dark place, after infusion, the resulting mixture can be used for rubbing and compresses.
Decoction of birch buds.
– 300 ml hot water plus a tablespoon of birch buds.
– Boil over low heat for 10 minutes, strain – you can wipe skin rashes with a swab soaked in the resulting broth.
Rubbing agent.
– 30 g of ground St. John’s wort, pour 200 ml of olive oil (other options are possible).
– Leave in a dry, dark place for 2 weeks, strain – another product for rubbing is ready.
A weak solution of potassium permanganate.
– Suitable for compresses, short baths;
Skin baths.
– By adding to water herbal infusions and decoctions (all water infusions) - chamomile, St. John's wort, sage, violet;
For oral administration.
– Any means with a general strengthening effect will do – tinctures of echinacea, leuzea, eleutherococcus, ginseng, aralia, calendula.

The listed activities should be carried out regularly, in courses, and not occasionally. Otherwise there will be little use.

Complications

The medical history of a person with Dühring's dermatosis rarely, but regularly, indicates the occurrence of negative phenomena caused by the course of the pathology.

The most famous include:

the contents of the bladder become cloudy, grayish or yellowish - a secondary infection has appeared, which can greatly increase inflammation;
development of hemorrhagic syndrome;
chronic, often and severely recurrent Dühring's dermatitis, especially in the absence of adequate therapy, can provoke an autoimmune attack on other tissues, and another autoimmune disease will begin, for example, rheumatoid arthritis;
Bubbles can appear again and again, leaving very unpleasant cosmetic marks on the skin that can only be eliminated with laser surgery.

Proper diet

The diet for Dühring's dermatitis is selected strictly individually.
Many foods are quite acceptable for the patient, dietary food is not a lifelong necessity.

If the patient’s gastrointestinal tract is normal (which, alas, happens infrequently), then seafood and sea fish in particular are not recommended. After all, seafood contains a lot of iodine, which is an irritant in dermatitis herpetiformis.

shrimps;
crabs;
mussels;
lobsters;
lobsters;
sea kale.

If a gastroenterologist also diagnoses a patient with celiac disease, then in most cases of this disease one has to go on a gluten-free diet for life.

Excluded:

wheat, rye flour and absolutely all products containing it;
cereals: barley, oatmeal, pearl barley;
cereal substitutes for natural coffee, whiskey, beer, kvass;
most of the usual sweets, because... All pastries, sweets, chocolates, cakes contain gluten.

After accurately confirming the diagnosis and identifying a clear relationship between the deterioration of the condition and the consumption of unwanted products, the person has to re-compile his menu.

fruits;
potatoes, carrots, zucchini, beets, greens;
compotes, jelly;
onions, garlic, nuts;
corn, buckwheat, rice (including flour from these crops);
vegetable and butter oils;
natural tea and coffee;
high-quality, completely natural cocoa and chocolate that does not contain gluten additives is acceptable;
olives;
whole milk, dairy products;
chicken, beef, especially lamb and turkey;
marshmallows, marmalade without gluten additives;
Unleavened types of bread are acceptable, and the product must be freshly prepared.

Prevention

Dermatitis herpetiformis, like many other human pathologies, is completely incurable. Those. if it arises, then, like osteochondrosis or gastritis, it will always accompany a person.

It is also impossible to prevent Dühring's disease due to genetic and immune mechanisms of development.

But you can make adjustments to your lifestyle so that remissions are long-lasting and exacerbations are short-lived and weak:

following a gluten-free diet;
avoiding any entry of iodine into the body: with food, medications, during medical procedures, when breathing;
it is necessary to try to eliminate or minimize all possible foci of infection in the body;
it is necessary to observe the rules of personal hygiene, but without fanaticism;
If possible, avoid areas with poor ecology and harsh climate;
it is necessary to minimize stress;
use hypoallergenic, softening skin creams;
be observed by a dermatologist, immunologist-allergist, and, if necessary, a gastroenterologist.

Some patients have doubts: Dühring's vesicular dermatitis can be very similar to a common exacerbation of the herpes simplex virus. And almost all of civilized humanity is infected with it.

How to distinguish herpes types 1 and 2 from Dühring's dermatitis?

Firstly, the localization of the rash - in patients with herpes it is almost always the nasolabial triangle, the genitals.
Secondly, with herpes there is no polymorphism.
Thirdly, an analysis of immunoglobulins for herpes will show increased Ig G and M, and for Dühring’s dermatitis - Ig A.

It is better for all patients to follow the doctor’s clinical recommendations and not neglect the prescribed course of treatment, even if the symptoms are mild. After all, the next exacerbation may be many times stronger. And the most important thing is the patient’s personal self-observation and self-education regarding his illness.

Conclusion

Despite its incurable, chronically relapsing nature, the disease described can easily be combined with a normal, comfortable life. Competently completed course of treatment during exacerbation and subsequent prevention with high degree Most likely, Dühring's dermatitis will turn into only “seasonal redness.”

Dühring's dermatitis herpetiformis is a skin disease with a chronic course and periodic relapses. A papular-erythematous rash, spots, blisters, and blisters resemble signs of herpes, hence the name.

Polymorphic skin rashes are more often recorded in men aged 20–60 years. Women get sick much less often. The rash is accompanied by burning and itching. A gluten-free diet is required.

Causes

Numerous studies have not yet yielded results - the exact cause of the development of the chronic disease has not been established. There are several theories.

Most likely reasons:

sensitivity to cereal protein - gluten, which is formed in the intestines for better absorption nutrients;
disruption of the endocrine system during menopause;
inflammatory diseases of the gastrointestinal tract;
allergic reaction to drugs, products containing iodine;
It is possible that the disease is caused by viruses herpetic infection, ARVI.

Provoking factors:

heavy physical activity;
frequent stressful situations;
vaccination;
toxemia – poisoning of cells, lymph, blood, secretions by toxins of various origins.

Localization areas

Rashes of bright red, often scarlet color are located on:

lower back;
shoulders;
elbows;
shoulder blades;
buttocks;
knees.

Sometimes papules, spots, blisters appear on other parts of the body. A characteristic sign is the absence of cases of rash on the feet and palms.

Symptoms and signs

It is difficult to look at a patient diagnosed with Dühring's dermatitis herpetiformis without compassion. Signs of pathology are clearly visible.

The disease is acute and chronic stage. How does a dermatological disease develop?

Main stages:

the first sign is the appearance of a characteristic rash in the form of blisters, spots, papules;
the rashes have a scarlet, bright red color and affect various parts of the body;
spots inside skin hemorrhages larger than 3 mm are often visible on the palms;
the body itches, there is a burning sensation;
the temperature rises to average values;
weakness is felt, the person feels “broken”, lethargic;
sleep deteriorates;
the patient is haunted by depression.

The disease is distinguished by the polymorphic nature of the rash. At the same time, several types of formations are present on the body - spots, blisters, vesicles, papules. This combination is rare.

After healing, areas with lighter skin and dark spots remain on previously affected areas. Severe cases lead to scarring.

Types of rash with dermatitis herpetiformis:

erythematous spots. Rounded shape of formations, clear boundaries. The top is covered with serous bloody crusts, itching leads to scratching of the affected areas;
blisters. They are formed from spots that gradually fill with liquid from dilated vessels. Soon the area covered with blisters increases, the formations merge, turning into foci of bluish-pink color. The top of the blisters is covered with scratches, small bubbles, and crusts;
Vesicles are one of the signs of Dühring's dermatitis. The size of the formations sometimes reaches 2 cm. The addition of infection is accompanied by turbidity of the thick fluid and the presence of blood clots. After opening the blisters and removing the crusts, the erosive surface is exposed;
scarlet spots often transform into papules different sizes. The color of the formations is pink-red;
sometimes blisters and bubbles appear on the body immediately, bypassing the stage of spots.

Note! There is no damage to the mucous membranes in most patients. Rarely, blisters occur in the mouth. Erosion soon forms in their place.

Forms of the disease

Dermatitis with a characteristic polymorphic rash is a chronic disease. Acute periods alternate with prolonged remission, lasting several months or more.

Exacerbation is accompanied by:

deterioration of health;
general weakness;
depressed state.

Rashes:

itchy, inflamed;
tissue infection often develops;
From constant scratching, the skin takes on a repulsive appearance.

Mental health suffers:

person is worried about appearance;
the patient narrows his social circle;
dietary restrictions worsen mood;
the result is prolonged depression.

Severe cases require inpatient monitoring. Polymorphic rash is more difficult to treat and requires complex therapy.

Treatment of the disease

At the first symptoms, visit a dermatologist. The sooner Dühring's dermatitis is diagnosed, the easier it is to achieve success and mitigate the course of the disease.

Diagnosis of the disease includes several tests. An accurate picture is established using:

Jadassohn's iodine test;
biochemical blood test;
checking the functioning of the thyroid gland;
cytological examination of the contents of papules, blisters;
histological analysis of skin from foci of inflammation.

Important! Dermatitis with polymorphic rash is a para-oncological disease. Old age is a reason to be additionally examined by an oncologist, to carry out computed tomography kidney, ultrasound abdominal cavity, take an x-ray of the lungs.

Therapy includes:

local remedies;
diet;
prescription of sulfonic group drugs;
using home remedies;
taking vitamin complexes.

Medications

Therapy is carried out under the guidance of a dermatologist. Mandatory activities:

taking medications of the sulfone group: Dapsone, Diaphenylsulfone, Diucifon, Autosulfone. Course – 5–6 days, break 1–3 days, then treatment is repeated until signs of dermatitis disappear;
Sometimes sulfone therapy is ineffective. The doctor prescribes corticosteroids - Dexamethasone, Prednisolone. Medium doses of potent drugs are recommended;
Antihistamines relieve signs of allergies and reduce itching. Suprastin, Erius, Zyrtec, Claritin are effective;
taking vitamins of various groups. Good effect give multicomponent vitamin complexes.

Local remedies will help alleviate the patient’s condition and get rid of rashes.

The skin is treated:

Fukortsin;
aniline dyes;
Dermatol ointment;
brilliant green solution;
anti-inflammatory sprays;
corticosteroid ointments.

baths with a weak solution of potassium permanganate;
reception restoratives: tinctures of aralia, echinacea, leuzea, eleutherococcus, ginseng. Remember– many tinctures are contraindicated for hypertensive patients.

Folk remedies and recipes

Take off painful sensations Home methods will help reduce itching, speed up the healing of scratches and erosions. Recipes traditional medicine indispensable for combating the manifestations of Dühring's dermatitis. Be sure to consult a dermatologist about certain home remedies.

Proven recipes:

infusion of medicinal herbs. Take 1 tbsp. l. knotweed, licorice root, calendula, juniper, sea buckthorn berries, tricolor violet, knotweed. Pour the collection with a liter of boiling water, leave for 2 hours. Take 2 tablespoons before meals. Drink the infusion daily. You can brew the herbs separately;
homemade ointment. Melt the interior pork fat. Grind belladonna herb (1 part), mix with fat (2 parts). Simmer the mixture in the oven at 90 C. Strain and lubricate the inflamed areas daily;
herbal tincture. Mix a tablespoon of tansy, juniper, calendula, nettle, yarrow, pour 0.5 liters of high-quality vodka. Leave in a dark place for 10 days. Strain and wipe the affected areas of the skin.

Remember! Folk remedies do not replace the effect of medications, but only enhance the positive effect of their use.

Diet for illness

Patients diagnosed with vesicular dermatitis herpetiformis A gluten-free diet is recommended. Excluding cereal proteins (wheat, barley, rye, oats, soy) will prevent pronounced allergic reactions.

For baking, use special gluten-free flour and thermophilic yeast. Lean on:

vegetables;
chicken;
seeds;
eggs;
nuts;
green salads;
fruits;
lactic acid products.

Remember! Sausage and semi-finished products also contain soy or wheat protein. Replace these foods with lean red meat.

Important point– prohibition of consumption of iodine-containing seafood. Remove from the menu:

shrimps;
sea fish, caviar;
mussels;
lobsters;
seaweed;
lobsters.

Most people know about the obvious benefits of valuable seafood due to their high iodine content. For patients with dermatitis with polymorphic rashes, eating seafood results in characteristic signs of allergy.

It is almost impossible to prevent the development of Dühring's dermatitis. Sometimes the disease manifests itself in childhood. Such patients often recover over time without specific treatment.

If you suspect herpetic vesicular dermatitis, stop taking products containing grains. A gluten-free diet is expensive and food is difficult to obtain. Many patients order special mixtures and products abroad.

Violation of nutritional principles results in serious consequences; rashes are difficult to treat. Do everything in your power to prevent complications.

Have you been diagnosed with Dühring's dermatitis herpetiformis? Follow a gluten-free diet, do not eat foods containing iodine, strengthen your body. Do not despair! There are worse diseases!

In the following video, a certified doctor from the Moskovsky Dvor clinic will tell you all the details about Dühring’s dermatitis:

Duhring's is a chronic skin disease with periodic relapses, the symptoms of which cause significant discomfort in patients - both physical and psychological. Treatment is carried out according to proven methods; prevention does not require significant effort, but only if the patient is sufficiently informed about his condition.

Description of Dühring's dermatitis herpetiformis

Dühring's dermatitis herpetiformis is a pathological condition first described by dermatology professor Louis A. Dühring in 1884. The typical symptoms of the disease, named by its discoverer as Dermatitis dolorosa, or painful dermatitis, were finally characterized by Louis Brock four years later.

Duhring's dermatitis herpetiformis is also known as Duhring's disease, Duhring's dermatosis, Broca's polymorphic dermatitis, Duhring-Broca's dermatitis, Fox's pruritic hydra, Fox-Crocker's hydra herpetiformis, Kaposi's pruriginous pemphigus.

The clinical picture, manifested in the form of a rash, blisters, spots on the skin, is very similar to a herpes infection. Based on this similarity, dermatitis herpetiformis received its modern name.

Forms of the disease

Visual learning skin rash plays a significant role in the diagnosis of Dühring's dermatitis. Depending on the prevailing type of rash (vesicles, papules, blisters), the so-called typical forms of the disease are described:

vesicular - the rash consists of bubbles (vesicles) slightly protruding above the surface of the skin;
papular - there are multiple nodules (papules) without voids;
bullous - multiple blisters (bullas) are formed, abundantly filled with fluid;
urticariform - short-lived blisters (urticaria) occur due to the detachment of the upper layer of skin.

If the formations merge with each other, transform, or undergo erosion, the clinical picture may demonstrate atypical forms of dermatitis. Among these, the most common are:

vegetative - branched foci of villous shape are formed;
localized - symptoms are expressed in a limited area of skin;
pemphigoid - the blisters are thicker than usual and break with great difficulty;
strophuloid - miniature bubbles appear at the tops of the nodules;
trichophytoid - the rash has wavy edges and is prone to peeling, which strongly resembles a fungal infection;
eczematoid - the lesions are covered with numerous blisters and nodules that quickly form wet erosions.

TO separate category refers to the so-called senile dermatitis, mainly caused age-related changes metabolism, inhibition of liver function, decreased activity of blood flow in the skin, and also, with some probability, serving as a sign of a neoplastic process in the body. This type is characterized by a changing rash of different sizes, forming atypical form diseases.

Causes and development factors

Among all dermatoses, the frequency of manifestations of Dühring's dermatitis is relatively small, amounting to approximately 0.2–0.48% of total number cases. Depending on the place of residence, dietary habits, origin, and many other factors, this indicator can fluctuate significantly. Thus, it has been proven that the descendants of the indigenous population of Northern Europe and Northern India, who have genes for hypersensitivity to gluten, are much more likely to develop dermatitis herpetiformis than the rest of the population of the planet.

Men aged 20 to 40 years are most susceptible to the disease. Women suffer from Dühring's dermatitis much less frequently. In children and people old age In addition to lower incidence, there are differences in the causes of dermatitis, and the severity of symptoms also differs.

The etiology of Dühring's disease remains unclear to this day. One of the first hypotheses seeking to explain the occurrence of dermatitis herpetiformis was infectious, which was later criticized. Viral, neurogenic and endocrine hypotheses are also debatable.

From the point of view of modern science, the most consistent version seems to be about an autoimmune origin, formed in the mid-60s of the twentieth century. The allergic hypothesis also has significant weight.

The autoimmune origin of Dühring's dermatitis is confirmed by the changes in the mucous membrane observed in patients small intestine. Histological studies demonstrate atrophy of intestinal villi of varying degrees, as a result of which malabsorption phenomena are frequent - difficulties in the absorption of nutrients and electrolytes. Sensitivity to gluten, a protein found in cereal plants, appears. The concentration of immunoglobulin A in the blood serum increases, the level of other immunoglobulins fluctuates significantly. Under the basement membrane of the intestinal epithelium, there is an active accumulation of autoantibodies to IgA. Changes in the tissues of the small intestine resemble clinical picture gluten enteropathy and celiac disease, as a result of which leading researchers raise the question, if not about the identity of these diseases, then about their common origin.

The allergic hypothesis is based on an increase in the blood level of eosinophils - cells involved in anti-allergic reactions. Also noteworthy is the decrease in the blood’s ability to inactivate histamine (the so-called histaminopexic index), the body’s acute sensitivity to bromine and iodine.

In some cases, Dühring's dermatitis acts as a para-oncological condition accompanying the development of a malignant tumor. Particular attention is required if the disease develops in old age.

Comparative table of hypotheses for the occurrence of the disease

Hypothesis	The essence	Criticism of the hypothesis
Autoimmune	Dermatitis occurs due to structural damage in the body caused by an attack by the body's own immune system.	The most confirmed hypotheses are often complementary.
Allergic	Dermatitis occurs due to foreign substances (iodine, bromine, organic toxins) entering the body.	The most confirmed hypotheses are often complementary.
Viral	Dermatitis is caused by exposure to the herpes virus.	The disease is sensitive to antiviral drugs Only in rare cases, the diagnostic picture does not correspond to a herpetic infection.
Infectious	Dermatitis occurs due to the proliferation of certain microorganisms on the surface of the skin.	Microorganisms are more likely to be a concomitant infection than a cause of the disease.
Neurogenic	Dermatitis occurs as a reaction of the body to disturbances in the functioning of the central nervous system, with exhaustion, stress.	Special cases, often explained by autoimmune and allergic disorders.
Endocrine	Dermatitis is caused by disruption of the endocrine glands.

Symptoms and signs

Dermatitis herpetiformis is characterized by an acute onset, which is often preceded by general weakness and a slight increase in body temperature. An itching and tingling sensation occurs on the surface of the skin, then the affected areas become covered with scarlet or bright red rashes. The most common places where the rash is localized are the bends of the knees and elbows, shoulders, shoulder blades, lower back, and buttocks. Occasionally, rashes are observed in the oral cavity, on the scalp, face, and neck. Typical sign for Dühring's disease is the absence of a rash on the soles and palms, although in the latter case the formation of large spots of subcutaneous hemorrhages is possible.

Over time, polymorphic and false polymorphic rashes form against the background of an edematous rash. Initially, round erythematous spots with a diameter of 0.2–0.5 cm are covered with serous crusts, scratches, filled with fluid from nearby vessels, transforming either into compacted papules or into blistering-like urticarial formations. Elements of the rash can also take the form of small vesicular rashes, or develop into large, over 2 cm, bullous formations.

At further development disease rashes merge, change shape, form various nodules and blisters, and collapse. The abrasions resulting from scratching become infected. The color of the rash changes to bluish-pink, and erosions appear under the opened blisters. After healing, areas with heterogeneous pigmentation are observed on the surface of the skin; particularly severe cases of the disease lead to the formation of deep scars.

Diagnostics

The Jadasson test is used as a rapid test that can detect dermatitis herpetiformis, but is not strictly specific. This method involves applying a compress with 50% potassium iodide ointment to the skin of the person being tested. At positive reaction, contact for 24 hours leads to the development of redness and polymorphic rashes.

An increased number of eosinophils on cytological examination of the fluid of the blisters is also indirect sign diseases. Biochemical analysis of the vesical fluid reveals a sharply increased content of prostaglandins.

The main diagnostic value is histological examination of the affected integument, which makes it possible to differentiate Dühring's dermatitis from true and non-acantholic pemphigus, subcorneal pustular dermatosis of Sneddon-Wilkinson, and toxicoderma. A typical picture of pathology is cavities under top layer skin, accumulation of fluid with numerous living and dead eosinophils contained in it, a decrease in the number of collagen fibers.

Carrying out an immunochemical blood test makes it possible to differentiate Dühring's disease from skin manifestations caused by herpes virus types 1 and 2. The analysis indicates the presence of immunoglobulins A specific to tissue transglutaminase, which indicates an autoimmune process, but there are no antibodies of classes G and M characteristic of herpes infection.

Treatment

Treatment of the disease involves an integrated approach - a combination of medications, lifestyle changes and physical therapy.

Local preparations

Local treatment of affected areas of the skin is carried out using warm baths containing potassium permanganate, followed by treatment with 1–2% solutions of aniline dyes and fucorcin. Anti-inflammatory ointments and sprays containing 2–5% naphthalan, dermatol, ichthyol, as well as corticosteroid drugs are highly effective.

General drug therapy

For general treatment antihistamines (Zyrtec, Claritin, Loratadine, Suprastin, Cetirizine, Erius) and corticosteroids (Prednisolone, Dexamethasone) are used to relieve painful symptoms. Drugs of the sulfone group (Dapsone, Diucifon) are used in combination with corticosteroids. Their use involves short courses of administration (5–6 days) with breaks of 1–3 days. It should be borne in mind that sulfones can change the state of the blood; their use requires regular biochemical tests.

In particularly severe cases of the disease, the use of detoxification drugs (Unitiol), blood and plasma transfusions is provided. Gamma globulin courses are effective in the amount of 5-6 injections of 1.5 ml, administered twice a week.

To improve the general condition of the body, it is recommended to take vitamins (A, B1, B2, B3, B6, B12, C, PP), preferably as part of vitamin complexes.

Physiotherapy

The first known physiotherapeutic method that could improve the condition of a patient with dermatitis was hydrotherapy. The use of baths and hot springs shows high efficiency to this day.

There is an assumption that one of the leaders french revolution Jean-Paul Marat suffered from severe form Dühring's disease. The only thing that brought him relief was warm baths with herbal mixtures, in which the revolutionary not only rested, but also wrote his works.

It is beneficial for the patient’s general condition to stay in areas with an improved climate (mountain, coniferous forest). Holidays near the sea should be treated with caution, since the content contained in environment Natural iodine can provoke an allergic reaction.

Effective for local treatment:

electrophoresis and phonophoresis with anti-inflammatory ointments;
ultraviolet irradiation, which reduces pain and promotes rapid healing;
laser therapy of the red and infrared spectrum, accelerating skin restoration;

Traditional treatment

Folk remedies, given the activity of some herbal ingredients, must be used in combination with drug treatment, and only after consultation with a dermatologist.

For external use, an ointment containing 1 part belladonna herb and 2 parts rendered internal fat is used. The mixture is ready for use after prolonged simmering at +90℃ and filtering; it should be lubricated daily on the affected areas of the skin. To wipe the rash, a herbal mixture infused in a liter of vodka, consisting of 2 tbsp. l. herbs calendula, nettle, juniper, tansy and yarrow. The tincture must be kept in the dark for 10 days.

Recommended for oral administration water infusions from calendula herb, knotweed, violet, juniper berries, sea buckthorn, licorice root. They can be brewed separately (1 tablespoon per liter of boiling water), or as part of a mixture. It is recommended to take 1 tbsp. l. twice a day, half an hour before meals.

Before using any folk remedies, you should consult your doctor, especially if you have concomitant diseases.

In order to increase the overall tone of the body, it is possible to take strengthening agents - tinctures of aralia, ginseng, eleutherococcus, echinacea. It should be remembered that the use of such drugs also increases the load on the cardiovascular system.

Nutritional Features

At the first manifestations of vesicular dermatitis herpetiformis, it is recommended to change the diet. Any products containing gluten, that is, those made from grains of oats, wheat, rye, soy, or barley, are prohibited. You should be wary of low-quality sausages, which often contain vegetable protein. It is not recommended to consume iodine-containing products (kelp, sea fish, shellfish), which can cause an allergic reaction.

The deficiency of fiber in the diet should be compensated by eating green salads, vegetables, fruits, and nuts. Lean red meat, chicken, and fermented milk products are very healthy. To prepare homemade baked goods, you need to use thermophilic yeast and gluten-free flour.

Foods you should avoid, pictured

Sweet chocolate often contains traces of gluten Gluten is added to minced meats Wheat, rye, oats, barley are not healthy for everyone In factory production, gluten is used as a stabilizer. Number of grain fillers in crab sticks often exceeds reasonable doses Children suffering from Dühring's dermatitis require careful selection of nutrition Some alcohols retain significant amounts of gluten
Wheat contains 10–15% gluten by weight Sea kale contains large amounts of allergenic iodine Like many other seafood, shellfish accumulate significant amounts of iodine

Selection of products for a gluten-free diet - video

Treatment prognosis and possible consequences

The prognosis is favorable with a timely diagnosis, properly selected treatment and following a diet. Comprehensive measures not only relieve symptoms, but also reduce the risk of relapse in the future. Dermatitis herpetiformis itself does not cause serious complications. The marks left on the skin after the polymorphic rash has healed are more of a cosmetic defect.

On the other hand, Dühring's disease is often a manifestation of hidden processes occurring in the body - autoimmune, neoplastic, hormonal. Ignoring these problems can further lead to the development of much more serious diseases: vitiligo, lupus, alopecia areata, sarcoidosis, Sjogren's syndrome. Disturbances in blood biochemistry can initiate problems with the thyroid gland. Damaged small intestinal epithelium becomes vulnerable to intestinal lymphoma.

Prevention

First and most effective method prevention is a change in diet. In the event that there is a hereditary predisposition to autoimmune diseases, gluten intolerance, or the first symptoms of Dühring's disease appear, it is recommended to switch to a gluten-free diet, exclude iodine-containing foods from the diet, and also pay special attention to a sufficient intake of vitamins.

Features of the disease in children

Children suffer from dermatitis herpetiformis much less frequently than adults, but the course of the disease often occurs in more acute form. The disease mainly manifests itself in the cold season. The primary symptoms are:

smooth increase in temperature to 39℃;
joint pain;
lack of appetite;
dyspepsia;
lethargy, or, on the contrary, excessive excitement.

Itching and rash can be located on any part of the body except the palms and soles. The lesions in most cases merge into figures irregular shape: rings, arcs, garlands, shapeless elements. Large, cherry-sized blisters filled with dark contents form on the skin of infants. Collapsed blisters easily form deep, weeping erosions.

A blood test indicates increased eosinophilia, leukocytosis, increased levels of lipids and abnormal immunoglobulins, and decreased albumin concentrations. Complications in the form of pyococcal infection are common, and the lymph nodes are enlarged in most cases.

Despite the severe course of the disease, accompanied by frequent relapses, children suffer from dermatitis herpetiformis with fewer negative consequences than people of mature age. Relapses usually subside during puberty.

Dermatitis herpetiformis (Dühring's dermatitis) is a chronic skin disease. It manifests itself as redness and swelling of certain areas of the skin, a rash in the form of blisters, blisters and papules, accompanied by burning and itching. Dühring's dermatitis is called herpetic because the rash is grouped in exactly the same way as with herpes. In order to identify the disease, a histological examination and analysis of the contents of the vesicles using direct immune fluorescence is prescribed. For treatment, drugs from the group of sulfones and corticosteroids are used.

Features of Dühring's dermatitis

The risk group for this disease has not been determined; dermatitis herpetiformis occurs in patients of any age and gender. But most often it is diagnosed in middle-aged men. In some cases, this is a skin reaction to a malignant tumor, that is, a para-oncological form. But more often the cause of the disease is factors typical for dermatological diseases. You can see what the areas of skin affected by Dühring's dermatitis look like in the photos below.

This type of dermatitis differs from most dermatological diseases in the variety of rashes. Blisters and papules, vesicles and spots can be observed on the skin at the same time.

Characteristic signs of Dühring's dermatitis:

Stains. They appear first, have clear contours and a smooth surface, and in their place blisters, papules and vesicles form.
Blisters. After 3-4 days they burst, after a while they become covered with crusts.
Papules. Small seals of a bizarre shape with bright red borders.
Bubbles. They are filled with a clear (sometimes cloudy) liquid and have a diameter of 2 to 20 mm.

Rashes are observed on the shoulders, elbows, lower back, buttocks and legs, and very rarely on the mucous membrane of the mouth. The affected areas are symmetrical, the skin may not change in appearance, but may become swollen or reddened. The disease has general symptoms. This is weakness and slight tingling in areas of rashes, severe itching and burning, slight increase in temperature and loose stool, insomnia or drowsiness, disorders of the thyroid gland and other organs.

Causes of Dühring's dermatitis

The causes of Dühring's dermatitis have not yet been established; the disease is considered unpredictable. The main factors that provoke the disease are similar to those that cause other dermatological diseases. This:

Genetic predisposition.
Weak immune defense.
Viral infections.
Pregnancy.
Hormonal imbalances.
Stress, excessive mental stress.
Intolerance to products containing gluten.
Presence of cancer cells in the body.
Disruption of the gastrointestinal tract.
Worms.

Despite the factors identified, most doctors believe that Dühring's dermatitis herpetiformis is a autoimmune pathologies(diseases associated with disorders of the immune system).

Dühring's dermatitis in children

Most often, the disease is diagnosed in male patients aged 15 to 60 years; women get sick less often, children – in exceptional cases. Typically, it is an itchy rash that quickly spreads throughout the body. Dermatitis herpetiformis in children develops for the same reasons as in adults, is accompanied by the same symptoms, and is treated with the same drugs. If a child develops symptoms of dermatitis, you should contact a pediatrician or dermatologist as soon as possible, who will prescribe the necessary tests for diagnosis and treatment.

In order to confirm the diagnosis, an external examination is not enough. Therefore, the doctor prescribes a number of studies:

Clinical blood test.
Examination of fluid from bubbles and blisters.
Histology.
Examination of the skin using the immunofluorescent method.
Biopsy.
Thyroid examination.

Most precise method The Jadasson test (for sensitivity to iodine) is considered. The Jadassohn test is named after the German doctor who developed this method. It consists of the following: a compress with ointment based on potassium iodide is applied to the skin area. If after a day rashes or redness appear at the site of the compress, it can be said that the patient has dermatitis herpetiformis.

Treatment of Dühring's dermatitis

Treatment of Dühring's dermatitis in adults is a set of measures that combines medication and a gluten-free diet. Most gluten is found in cereals, so bakery and baked goods are excluded from the diet. pasta, porridge based on wheat, rye, oats and barley, legumes, cabbage, kvass, coffee, beer, desserts. If the disease proceeds without complications, the doctor prescribes medications from the sulfone group - Sulfapyridine, Diucifon or Dapsone. If the course of the disease is more severe, corticosteroid drugs are prescribed - Dexamethasone, Prednisolone or Methylprednisolone. In order to reduce itching, take antihistamines - Claritin, Citrine or Erius, to strengthen the body - vitamin complexes - Neurovitan, Supradin or Vitrum.

In addition to tablets, local agents are used - the rash is treated with fucorcin or methylene blue, hormonal ointments, suspensions, and sprays are used. To relieve inflammation, apply compresses with a solution of potassium permanganate.

Folk remedies are used as additional treatment:

St. John's wort oil. Grind 30 g of St. John's wort leaves and flowers, pour 200 ml vegetable oil. Leave to infuse for 1.5-2 weeks. Filter, lubricate the affected areas of the skin 2-3 times a day.
St. John's wort based ointment. Boil St. John's wort juice in a water bath until thickened, let cool. Mix with butter in a ratio of 1:4. The ointment softens the skin, heals wounds, disinfects and destroys germs.
Decoction of birch buds. Pour 1 cup of birch buds into 300 ml of water, put on fire, and bring to a boil. Keep on fire for 15 minutes, let cool, strain. Wipe the rash areas 3-5 times a day. The decoction soothes, relieves itching and inflammation.
Tea with lemon balm. Brew 1-2 teaspoons of lemon balm in 200 ml of boiling water, let cool. You can drink it at any time, 2-3 times a day, after meals instead of tea. The product has anti-inflammatory and restorative properties.

A doctor should select a treatment regimen and prescribe medications; self-medication can lead to secondary infection and dermatitis becoming severe.

Complications of Dühring's dermatitis

To ensure that dermatitis herpetiformis does not cause complications, the doctor monitors the progress of treatment and periodically prescribes tests. In some cases, the disease is accompanied by nausea and vomiting; in severe cases, hospital treatment is required. If this does not happen, dermatitis will develop into a more dangerous form for health, and the risk of contracting a secondary infection will increase significantly. Acute periods will alternate with remission, which lasts for several months. The patient will suffer from itching and burning, and his skin will take on a repulsive appearance. The person will worry about his appearance, reduce communication to a minimum, and lose sleep and appetite. The result is a violation mental health and prolonged depression.

Prevention of Dühring's dermatitis

Dühring's dermatitis in adults is a chronic disease; complete recovery is observed in exceptional cases. If you are predisposed to the disease, follow these simple rules:

Follow a gluten-free diet.
Avoid foods high in iodine.
Take iodine-containing medications under medical supervision.
Provide yourself good rest and healthy sleep.
Take regular walks in the fresh air.
Avoid stress, overheating and hypothermia.
Lead a healthy, active lifestyle.

Unfortunately, Dühring's dermatitis is often accompanied by severe relapses, especially dangerous for older people. But it is impossible to predict the course of the disease and the course of treatment. Only timely contact a dermatologist, complex therapy and following the doctor’s recommendations will allow you to get rid of the disease and return to a full life. The disease is difficult to treat, so it requires a lot of patience and a positive attitude.