Facial Involvement in Dermatitis Herpetiformis: A Case Report and Review of the Literature

Cinats, Allison K.; Parsons, Laurie; Haber, Richard M.

doi:10.1177/1203475418795818

Cited by 6 publications

(11 citation statements)

References 8 publications

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“…When dapsone is causing major side effects or is otherwise contraindicated, sulfasalazine or rituximab can help [84]. Topical dapsone 5% gel, available in the USA and Canada, is free from systemic side effects and seems moderately efficient in the treatment of localized DH lesions on the face and chest [85,86].…”

Section: Dapsonementioning

confidence: 99%

Dermatitis Herpetiformis: An Update on Diagnosis and Management

2021

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Dermatitis herpetiformis (DH), presenting with an intense itch and blistering symmetrical rash, typically on the elbows, knees, and buttocks, is a cutaneous manifestation of celiac disease. Though overt gastrointestinal symptoms are rare, threefourths of patients with DH have villous atrophy in the small bowel, and the rest have celiac-type inflammatory changes. DH affects mostly adults and slightly more males than females. The mean age at onset is about 50 years. DH diagnosis is confirmed by showing granular immunoglobulin A deposits in the papillary dermis. The DH autoantigen, transglutaminase 3, is deposited at the same site in tightly bound immune complexes. At present, the DH-to-celiac disease prevalence is 1:8. The incidence of DH is decreasing, whereas that of celiac disease is increasing, probably because of improved diagnostics. In DH, the treatment of choice for all patients is a gluten-free diet (GFD) in which uncontaminated oats are allowed. At onset, most patients need additional dapsone to rapidly control the rash and itching. Dapsone can be stopped after a mean of 2 years, and a strict lifelong GFD alone is required. Dietary adherence offers an excellent long-term prognosis for patients with DH, with a normal quality of life and all-cause mortality.

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Section: Dapsonementioning

confidence: 99%

Dermatitis Herpetiformis: An Update on Diagnosis and Management

2021

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“…Other regions that are often affected include the scalp, neck, upper back, and sacral region. The face and groin; however, can also be affected [ 1 , 10 , 11 ]. The eruption is usually polymorphic, consisting of groups of erythematous papules, urticarial plaques, and vesicles.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Methylene blue should be avoided in patients with G6PD deficiency as it can cause severe hemolysis, in which case vitamin C should be given instead [ 75 ]. If oral dapsone and its alternatives are not an option, topical dapsone 5% gel may be considered for mild diseases, as it is free of systemic side effects and appears to be moderately effective at treating localized face and chest lesions [ 10 , 76 ].…”

Section: Managementmentioning

confidence: 99%

Dermatitis Herpetiformis: An Update on Diagnosis, Disease Monitoring, and Management

Nguyen

Kim

2021

Medicina

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Dermatitis herpetiformis (DH), Duhring disease, is caused by gluten sensitivity and affects 11.2 to 75.3 per 100,000 people in the United States and Europe with an incidence of 0.4 to 3.5 per 100,000 people per year. DH is characterized by a symmetrical blistering rash on the extensor surfaces with severe pruritus. The diagnosis continues to be made primarily by pathognomonic findings on histopathology, especially direct immunofluorescence (DIF). Recently, anti-epidermal transglutaminase (TG3) antibodies have shown to be a primary diagnostic serology, while anti-tissue transglutaminase (TG2) and other autoantibodies may be used to support the diagnosis and for disease monitoring. Newly diagnosed patients with DH should be screened and assessed for associated diseases and complications. A gluten-free diet (GFD) and dapsone are still mainstays of treatment, but other medications may be necessary for recalcitrant cases. Well-controlled DH patients, managed by a dermatologist, a gastroenterologist, and a dietician, have an excellent prognosis. Our review comprehensively details the current diagnostic methods, as well as methods used to monitor its disease course. We also describe both the traditional and novel management options reported in the literature.

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“…Erythematous lesions or intense pruritus were described as the only DH symptoms ( fig. 4) [29], and exanthemata involving the face only [30]. Involvement of oral mucous membranes is extremely rare (1-10% of patients) -erosions, small ulcers, or aphthae with accompanying sensation or dryness and burning in the oral cavity.…”

Section: Wprowadzeniementioning

confidence: 99%

“…Opisano zmiany rumieniowe lub intensywny świąd jako jedyny objaw DH (ryc. 4) [29] oraz zmiany występujące tylko na twarzy [30]. Zajęcie błon śluzo- Persistent pruritus is characteristic; less often patients experience burning, pricking, or stinging sensation of the skin that appears or intensifies 8-12 hours before appearance of new skin lesions, and then accompanies them.…”

Section: Obraz Klinicznyunclassified

Clinical picture of dermatitis herpetiformis

Rybak-d'Obyrn¹,

Placek²

2019

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Dermatitis herpetiformis is a rare, chronic, autoimmune blistering disease with hypersensitivity to gluten with the presence of intense pruritus. Symptoms of the disease are symmetrical, polymorphic skin lesions in a typical location. It is thought that dermatitis herpetiformis is a specific skin manifestation of celiac disease, with frequent asymptomatic gluten enteropathy. Both diseases are characterized by the same tissue compatibility antigens, the presence of circulating IgA antibodies against endomysium and transglutaminases, and clinical remission on a glutenfree diet. Non-adherence to this diet predisposes to the development of some tumours, autoimmune and thyroid gland diseases. The diagnosis of dermatitis herpetiformis is based on the findings of the characteristic IgA deposits in the skin papilla in the direct immunofluorescence test. Specific serum antibodies are used as an aid in the diagnosis and for monitoring the compliance with gluten free diet. streszczenieOpryszczkowate zapalenie skóry jest rzadką, przewlekłą, autoimmunologiczną chorobą pęcherzową, przebiegającą z nadwrażliwością na gluten i obecnością intensywnego świądu. Skórną manifestacją jest występowanie symetrycznych, polimorficznych zmian skórnych grupujących się w układzie opryszczkowatym w typowej lokalizacji. Schorzenie to jest specyficzną skórną manifestacją choroby trzewnej, z często utajoną enteropatią glutenową. Obie choroby charakteryzuje związek z tymi samymi antygenami zgodności tkankowej, obecnością krążących przeciwciał IgA przeciwko endomysium mięśni gładkich i transglutaminazom oraz kliniczna remisja pod wpływem diety bezglutenowej. Nieprzestrzeganie diety bezgutenowej predysponuje do rozwoju niektórych chorób nowotworowych, autoimmunologicznych i chorób tarczycy. Rozpoznanie opiera się na stwierdzeniu w badaniu immunofluorescencji bezpośredniej charakterystycznych złogów IgA w brodawkach skóry. Oznaczanie swoistych surowiczych przeciwciał wykorzystuje się pomocniczo w diagnostyce oraz do monitorowania przestrzegania diety.

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Facial Involvement in Dermatitis Herpetiformis: A Case Report and Review of the Literature

Cited by 6 publications

References 8 publications

Dermatitis Herpetiformis: An Update on Diagnosis and Management

Dermatitis Herpetiformis: An Update on Diagnosis and Management

Dermatitis Herpetiformis: An Update on Diagnosis, Disease Monitoring, and Management

Clinical picture of dermatitis herpetiformis

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