Dühring'sdisease(dermatitis herpetiformis), otherwise known as dermatitisherpetiformis or the cutaneous form of coeliac disease, affects patients between the ages of 14 and 40.
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This is actually a skin and intestinal disorder, where the lesions that appear on a person's skin are related to their intolerance of gluten. The consequence is the deposition of type A immunoglobulin deposits, most commonly and most abundantly in the area of the skin papillae. The skin lesions cover the elbows, knees, buttocks, face, head and shoulder blades and, importantly, may also appear in the dentition. The disease is very common in families where there are people with coeliac disease.
Symptoms characteristic of Dühring's disease
Among the most characteristic and visible symptoms of Dühring's disease are the lesions that appear on the patients' skin, in the form of spots, vesicles, papules or erythema. In the initial phase of the disease, the lesions are not immediately visible; the skin looks quite healthy. Over time, they appear and involve the buttocks, elbows, back, face, and are very itchy or burning. The lesions can be flat or protruding. Patients, very often scratch them which in turn leads to scabs and then scarring.
People with Dühring's disease also have problems with their digestive system due to the loss or reduction of intestinal villi. Patients also experience anaemia, fatigue and depression. Importantly, sufferers have defects in their dental enamel.
Skin symptoms are exacerbated after eating certain products (containing iodine) and when taking certain medications.
Dühring's disease, photo: pantherstock
Diagnosis and treatment of Dühring's disease
In order to diagnose Dühring's disease, the doctor, taking a detailed history of the patient and his family, performs a skin biopsy (a sample is taken from the buttock, an area not affected by the disease) for unequivocal confirmation. An IgA assay is also performed from the patient's blood. If the results are positive, a biopsy of the small intestine is also performed. Treatment of this disease consists, in most cases, of the exclusion of gluten from the patient 's diet (completely gluten-free diet), restriction of iodine intake and, if necessary, the inclusion of pharmacological agents.
The first changes on the skin of the affected person, are visible after about 6 months. This is, however, individual for some patients and may even be years. A person affected by Dühring's disease remains under constant medical supervision.
