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Dermatitis, herpetiformis - close-up of lesion
Dermatitis, herpetiformis - close-up of lesion

Dermatitis, herpetiformis on the knee
Dermatitis, herpetiformis on the knee

Dermatitis, herpetiformis on the arm and legs
Dermatitis, herpetiformis on the arm and legs

Dermatitis, herpetiformis on the thumb
Dermatitis, herpetiformis on the thumb

Dermatitis, herpetiformis on the hand
Dermatitis, herpetiformis on the hand

Dermatitis, herpetiformis on the forearm
Dermatitis, herpetiformis on the forearm

Dermatitis herpetiformis

Definition:

Dermatitis herpetiformis is an extremely itchy rash made of bumps and blisters. The rash is chronic, which means it continues over a long period of time.



Alternative Names:

Duhring's disease



Causes, incidence, and risk factors:

Dermatitis herpetiformis usually begins in people age 20 and older, although children may sometimes be affected. It is seen in both men and women.

The cause is unknown. However, dermatitis herpetiformis is frequently linked to gluten sensitivity (celiac sprue disease ) in the small bowel.



Symptoms:

Symptoms of dermatitis herpetiformis include:

  • Extremely itchy bumps or blisters, most often on the elbows, knees, back, and buttocks
  • The rash is usually the same size and shape on both sides
  • Some patients may have scratch marks instead of blisters

Symptoms of dermatitis herpetiformis tend to come and go.



Signs and tests:

A skin biopsy and direct immunofluorescence test of the skin are performed in most cases. Your doctor may also recommend a biopsy of the intestines.



Treatment:

An antibiotic called dapsone may help most patients.

A strict gluten-free diet will also be recommended to help control the disease. Sticking to this diet may remove the need for medications and prevent later complications.

Certain immunosuppressive medications may be used but are less effective.



Expectations (prognosis):

The disease may be well controlled with treatment. Without treatment, there may be a significant risk of intestinal cancer.



Complications:

Thyroid disease may be found in many patients with dermatitis herpetiformis. Patients are also more likely to develop certain cancers of the intestines.



Calling your health care provider:

Call your health care provider if you have a rash that continues despite home treatment.



Prevention:

There is no known prevention of this disease. People with this condition may be able to prevent complications by avoiding foods that contain gluten.



References:

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004.

McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. St. Louis, Mo: WB Saunders; 2006.



Review Date: 5/13/2011
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network.  Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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