Celiac disease and herpetiform dermatitis

Thursday, 11 March 2021 / Published in Insights
Celiac disease and herpetiform dermatitis

The term herpetiform has been attributed for the particular manifestations of this dermatitis, with the appearance of particular blisters, bubbles and crustaceans, which recall the typical signs left by the aforementioned virus.
The wording "Duhring", however, is due to the doctor who identified and described the disease, for the first time, in 1884. Later, in 1988, the disease in question was also clinically described by Brocq (hence the name of "Brocq’s painful polymorphic dermatitis").
Fortunately, Duhring’s dermatitis is one of the rare diseases, with an incidence of one person per 10,000, manifests itself in young people and adults and it is very rare that herpetiform dermatitis affects infants and the elderly. 
Although it is rare in infants, herpetiform dermatitis may manifest its first symptoms in adolescence, with higher incidence in female individuals. In contrast, in adulthood, male individuals are most affected.
Statistics also relate herpetiform dermatitis to coeliac disease: the skin disorder occurs every five people with coeliac disease. In fact, not necessarily all celiac individuals also suffer from this skin disease. On the contrary, an individual suffering from Duhring’s dermatitis will definitely suffer from coeliac disease. Duhring’s dermatitis is classified as a bullous autoimmune dermatosis, dermatitis can be considered the skin effect of a food intolerance to gluten:gluten is the cause of the abnormal antibody response (Iga - immunoglobulin type A) responsible for dermal manifestation.
As it happens for many pathologies that afflict man, the best treatment currently available to counter herpetiform dermatitis is prevention.
More precisely, in the specific case of Duhring’s dermatitis, prevention must be carried out through the adoption of a particular diet, which may be combined with a possible pharmacological treatment to alleviate the typical symptomatology of the disease.
As just mentioned, in order to prevent the onset of skin manifestations of herpetiform dermatitis - but also of coeliac disease itself -It is very important to adopt a specific diet, which should be totally free of foods containing gluten.
A gluten-free diet is, in fact, the only possible treatment, able to completely eradicate the triggers. If this is not enough, on the advice of the doctor, it is possible to use specific medicines.

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