During’s herpetiform dermatitis is a skin disease, in most cases occurring in a chronic form and having the ability to relapse. The patient has a polymorphic rash, manifested in the form of blisters, erythematous spots and blisters. These symptoms cause a feeling of itching, tingling, burning. Due to the similarity in the very process of the appearance and grouping of the rash, During’s disease is called herpetiform dermatitis.
The content of the article:
Causes of During’s herpetiform dermatitis
Symptoms of During’s herpetiform dermatitis
Diagnosis of During’s herpetiform dermatitis
Treatment of During’s herpetiform dermatitis
During’s herpetiform dermatitis
The disease is characteristic of middle-aged people, men are more often exposed to it than women. In some cases, During’s herpetiform dermatitis occurs as paraoncological dermatosis, that is, as a reaction to the presence of a malignant tumor in the patient’s body.
The treatment of During’s herpetiform dermatitis combines the use of corticosteroids and sulfonic drugs.
Causes of During’s herpetiform dermatitis
The disease “During’s herpetiform dermatitis” is well studied, and doctors can fully describe the causes and factors that caused its onset.
It is believed that the disease has an autoimmune nature. However, the reason for its occurrence may be intolerance to gluten protein, which is in excess in the products of cereal plants: bakery products and some cereals.
Also, the autoimmune nature of During’s herpetiform dermatitis is indicated by the diagnosis of antibodies located in the basement membrane area at the border of the epidermis. The nature of the action of these antibodies is expressed in the fact that the body makes attempts to attack its own cells, filling the broken intercellular connections with liquid and forming bubbles.
In addition, the causes of During’s herpetiform dermatitis include:
sensitivity to iodine;
the corresponding heredity of the patient;
gastritis;
ulcer;
ascariasis;
inflammation in the gastrointestinal tract;
ARVI;
herpes infection;
viral diseases.
Also, During’s herpetiform dermatitis occurs as a reaction to cancer. Then it qualifies as paraoncological dermatitis and is diagnosed as a consequence of the presence of a malignant tumor in the patient’s body.
Symptoms of During’s herpetiform dermatitis
The onset of the disease is characterized by the manifestation of primary symptoms — foci of polymorphic rash. This is preceded by manifestations of general malaise: fever, weakness, chills. There is also itching and burning, tingling in all parts of the body. It is noteworthy that the rashes that most often occur on the extensor surfaces of the arms and legs, with a high degree of probability, can appear on any part of the human body: back, lower back, abdomen; however, they never appear on the palms or feet. Petechiae and ecchymoses may occur on them — large spots formed due to internal hemorrhage.
Bubbles appear in the oral cavity, turning into erosion after rupture.
The main stage of the disease manifests itself when the whole spectrum of possible rashes appears on the patient’s body at the same time: blisters, blisters, papules, erythematous spots. This process is called “rash polymorphism”. In addition, at this stage of the course of the disease, false polymorphism also occurs, manifested in the formation of crusts, erosions, excoriation, hyperpigmentation of scars. Many of these symptoms are the result of constant friction, scratching, tearing of wounds by the patient, which is not surprising if we take into account the constant itching and tingling sensation in the rash foci.
A characteristic symptom of the disease is the fact that erythematous spots have a well-defined contour and a round shape. Their surface is smooth, but it is often covered with crusts consisting of either blood or sulfur. Also, erythematous spots are covered with traces of scratching, because they cause an unbearable itching sensation in the patient.
Dilated vessels nourish the spots with sweat, which turns them into large formations similar to blisters. These bubbles tend to merge, form large foci of blue and red color, which are also covered with combs, crusts and bubbles. In parallel, erythematous spots can turn into papules with a bright crimson hue.
According to the nature of the rashes and what stage of the disease the doctor observes, the diagnosis of herpetiform dermatitis of During is carried out. There are several types of this disease, defining them by the type of rash:
papular;
vesicular;
bullous;
urticaria-like.
Atypical varieties of During ‘s herpetiform dermatitis include:
trichophytoid;
eczematoid;
strofuloid and other types of disease.
The general picture of During’s herpetiform dermatitis suggests that the remission of the disease can be quite long — the period lasts from several months to several years. At the moments of exacerbation of the disease, all the symptoms described above are combined with sleep disorders, increased body temperature, weakness and malaise.
Diagnosis of During’s herpetiform dermatitis
If a patient turns to a specialist with complaints of symptoms similar to the manifestations of During’s herpetiform dermatitis, then the first thing he is prescribed is a Jadassone iodine test — the main analysis carried out to diagnose this disease. A compress containing 50% potassium iodide is applied to a lesion-free area of the skin for a day. If a characteristic rash occurs on this area of the skin, then the diagnosis of During’s herpetiform dermatitis is positive, and if the test showed a negative reaction, it must be repeated. The second time the compress is applied to the hyperpigmentation zone, which remains after the missing rashes, and it is removed after 48 hours. Such an analysis can also be carried out by taking potassium iodide inside the patient, but this method is rarely prescribed due to the danger of exacerbation of herpetiform dermatitis of During.
A clinical blood test shows an increased amount of eosinophils in the material, the same result reveals the contents of the bubbles. However, such a study will not unequivocally indicate the presence of herpetiform dermatitis of During.
Histological analysis is considered to be the most plausible, examining the skin and finding neutrophils, eosinophils and remnants of nuclei, autoimmune manifestations under it.
Since it is known that the disease can occur as a reaction to an oncological tumor, patients are also prescribed additional studies aimed at confirming or refuting the presence of malignant formations in the body.
Treatment of During’s herpetiform dermatitis
The doctor who prescribes studies, tests and treatment must be a qualified specialist in the field of dermatology.
The patient is shown to exclude cereals and iodine-containing products from the daily diet. Complex treatment includes the use of medications. In cycles of five to six days with short breaks, treatment with dapsone, DDS, sulfapyridine and other drugs of the sulfone group is necessary. In the unsuccessful case, therapy is replaced with corticosteroids.
Symptoms of the disease are treated separately: the patient is prescribed medications that reduce the sensation of itching, burning and tingling. It can be claritin, erius or other medications of the antihistamine group.
Warm baths with a weak solution of potassium permanganate are prescribed to relieve the soreness of manifestations of During’s herpetiform dermatitis.
