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    Dermatitis Herpetiformis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Dermatitis Herpetiformis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Dermatitis Herpetiformis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook101 pages59 minutes

    Dermatitis Herpetiformis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    This book describes Dermatitis Herpetiformis, Diagnosis and Treatment and Related Diseases
    Dermatitis herpetiformis is a rare but continual immunobullous disease that has been linked to celiac disease, a gluten-sensitive enteropathy.
    The name herpetiformis is obtained from the tendency for blisters to happen in clusters, similar to herpes simplex.
    Dermatitis herpetiformis is not caused by viral infection.
    Dermatitis herpetiformis is also termed Duhring-Brocq disease
    Dermatitis herpetiformis (DH) is a very itchy rash comprising bumps and blisters.
    The rash is persistent (long-term).
    Incidence
    DH normally starts in people age 20 and older.
    Children can occasionally be involved.
    Dermatitis herpetiformis mainly involves Caucasians aged 15–40 years but may happen in those younger or older and in other races.
    It is observed in both men and women.
    There is a 2:1 male-to-female ratio.
    More females under the age of 20 are involved than males.
    There is a genetic predilection with a link with human leukocyte antigens (HLA) DQ2 and DQ8.
    Some patients have a personal or family history of other autoimmune diseases such as thyroid disease, pernicious anemia, type 1 diabetes, vitiligo, Addison disease and alopecia areata
    Causes
    The precise cause is not known.
    In spite of the name, it is not linked to the herpes virus.
    DH is an autoimmune disorder.
    There is a strong link between DH and celiac disease.
    Celiac disease is an autoimmune disorder that produces inflammation in the small intestine from eating gluten.
    People with DH also have allergy to gluten, which produces the skin rash.
    About 25% of people with celiac disease also have DH.
    Dermatitis herpetiformis and celiac disease are caused by intolerance to the gliadin fraction of gluten present in wheat, rye and barley.
    Gluten precipitates formation of IgA antibodies and an autoimmune process that aims the skin and intestines.
    In celiac disease, gluten produces intestinal inflammation causing diarrhea, tiredness, weight loss and abdominal discomfort.
    The main percentage (> 90%) of patients with dermatitis herpetiformis also have gluten-sensitive enteropathy.
    Gastrointestinal symptoms can be mild to severe; some patients stay symptom-free.
    Around 15–25% of celiac patients have concomittent dermatitis herpetiformis.
    These patients are likely to have a more severe intestinal pathology compared to those with mainly dermatitis herpetiformis.
    Symptoms are:
    1. Extremely itchy bumps or blisters, most often on the elbows, knees, back, and buttocks.
    2. Rashes that are normally the same size and shape on both sides.
    The rash can similar to eczema.
    3. Scratch marks and skin erosions instead of blisters in some people.
    Most people with DH have injury to their intestines from eating gluten.
    Diagnosis
    In most cases, a skin biopsy and direct immunofluorescence test of the skin are performed.
    Skin biopsy is usually necessary to confirm dermatitis herpetiformis.
    Treatment
    Strict adherence to gluten-free diet reduces this rare but serious long-term complication
    Gluten-free diet for life is strongly recommended in patients with dermatitis herpetiformis, as it:
    1. Reduces the requirement for medication to control dermatitis herpetiformis
    2. Improves associated gluten-sensitive enteropathy
    3. Enhances nutrition and bone density
    4. May reduce the risk of developing other autoimmune conditions
    5. May reduce the risk of intestinal lymphoma
    Dapsone is the treatment of choice for dermatitis herpetiformis, as it usually reduces itch within 3 days.
    If intolerant or allergic to dapsone, these may be useful:
    1. Ultra-potent topical steroids
    2. Systemic steroids
    3. Sulfapyridine
    4. Rituximab
    Immuno-suppressants are less effective.

    TABLE OF CONTENT
    Introduction
    Chapter 1 Dermatitis Herpetiformis<

    LanguageEnglish
    PublisherKenneth Kee
    Release dateOct 20, 2019
    ISBN9780463338957
    Dermatitis Herpetiformis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Dermatitis Herpetiformis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

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