Duhring Disease, A Rare Autoimmune Disease Diagnosis and Management: A Review Article

Abstract

Introduction: Dermatitis herpetiformis or also known as Duhring's Disease or gluten rash is an autoimmune vesicobulose disease, this disease is not related to dermatitis, nor is it caused by the herpes virus, but a specific and recurrent chronic skin condition associated with celiac disease and gluten-sensitive enteropathy. The main predisposing factor is genetics, this is related to Human Leukocyte Antigens (HLAs) DQ2 and DQ8. Dermatitis herpetiformis can affect any age but appears more often for the first time in young adults between the ages of 30 and 40, more often in men than in women, where the lesions in men are common in the mouth and genitalia. Discussion:The main lesions are erythematous papules, plaques, urticaria, or most commonly vesicles, of which large bullae rarely occur. The lesions seen in people with dermatitis herpetiformis may be crusted and may not show the main lesion. On physical examination, excoriation and erosion are common. The distribution of lesions in dermatitis herpetiformis is symmetrical with a frequent predilection of the extensor surfaces of the forearms, elbows, shoulders, knees, buttocks and back. The main therapeutic management of dermatitis herpetiformis is a gluten-free diet. Adherence to a strict gluten-free diet resulted in resolution of symptoms of dermatitis herpetiformis and a positive development of intestinal pathology. Despite implementing a non-strict gluten-free diet, the accumulation of IgA in the dermoepidermal junction in dermatitis herpetiformis patients will slowly disappear and may take several years to completely disappear. Conclusion:The management of patients with dermatitis herpetiformis should be a team consisting of a dermatologist, a gastroenterologist and a nutritionist. Patients require follow-up to monitor long-term medication use and control recurrence of symptoms. Regular visits will facilitate screening and early detection of autoimmune conditions or neoplasms that may be associated with dermatitis herpetiformis and to obtain referral therapy for patients experiencing them.

A Rare Case of COVID-19-Induced Acute Exacerbation of Oral Dermatitis Herpetiformis in a Geriatric Patient

“…10 The pathophysiology of DH involves a complex set of autoimmune factors such as genetic and environmental predisposition. 3 Human leucocytes antigen (HLA) DQ2 or DQ8 is a predisposing factor for DH. 11 DH and CD are autoantibody responses to tissue transglutaminase (TG) 2 in serum and small intestinal mucosa.…”

“…1,2 DH lesions in males are generally found in the mouth and genitals. 3 Dermatitis herpetiformis is a rare vesiculobullous dermatitis and is more common in Scandinavian countries and the United Kingdom. Studies conducted in Finland show that the prevalence of DH is 10.4 per 100,000 population.…”

“…4 The prevalence of DH in Caucasians is 10 per 100,000 population. 3 The clinical manifestation of DH is the occurrence of a papulovesicular rash on the skin. The lesions are often located on the elbows, extensor surfaces of the forearms, knees and buttocks.…”

Dental diseases in patients with pathology of the gastrointestinal tract: a literature review

“…Одним із найпоширеніших позакишкових проявів целіакії вважають герпетиформний дерматит Дюрінга, який за сучасними уявленнями [31] Карієс зубів є одним з найпоширеніших стоматологічних захворювань. Поступово каріозне ураження призводить до виникнення ускладнень, повного руйнування зубів, може стати причиною багатьох хроніосептичних станів в організмі людини [21].…”