Dermatitis Dühring is a skin disease, the cause of which is not clear. The disease is characterized by a long course with paroxysmal appearance on the skin of the trunk and extremities of an itchy rash in the form of blisters, vesicles grouped into rings, half rings and garlands.
People from 15 to 60 years of age are most susceptible, with a peak frequency of 30–40 years. Men get sick more often.
Signs of dermatitis Dühring are blisters, red spots, tense bubbles on the edematous reddened background (they can also appear on unchanged skin) with a pronounced tendency to grouping and ring-shaped.
The bubble cap is thick, the contents are clear at first, then cloudy. Bubbles can turn into ulcers, open with the formation of ulcerations on the edematous background, on the edge of which there are visible caps of the bubbles. On the surface of ulcerations, crusts form under which healing takes place.
The most typical arrangement of dermatitis Dühring: elbows, extensor surfaces of the forearms, in 1/3 of the cases elements occur on the face and neck, less often affects the buttocks, knees, sacrum, back of the head.
Burning and itching are so strong that scratching often masks the primary rash. The general condition of patients during an exacerbation can be broken.
The diagnosis is made by a dermatologist with the help of laboratory and instrumental methods:
Determining the number of eosinophils in the blood and cystic fluid: a significant increase.
In the study of the functions of the thyroid gland in 30% of all cases reveal various violations.
Sample with iodine: on the forearm under a compress for 24 hours impose ointment with 50% potassium iodide. In case of a positive test, redness and rashes appear on the site of application of the ointment.
Direct immunofluorescence reveals accumulation of fixed immunoglobulins A.
Before starting treatment, patients with Dühring dermatitis should be examined to detect diseases of the gastrointestinal tract and malignant tumors.
A diet with the exception of wheat, oats, millet, barley and other cereals, as well as products containing iodine (sea fish) is shown.
Dapsone – 100 mg 2 times a day for 5 days with 1-2 days breaks (3-5 cycles or more). After the disappearance of the manifestations of the disease is prescribed in a maintenance dose (5 mg every other day or 1-2 times a week). Side effects of dapsone: nausea, vomiting, anemia, liver damage, psychosis, allergic reactions; Dapsone is incompatible with amidopyrine and barbiturates.
Besides dapsone as sodium dimerakoptopropansulfonat applied, methionine, lipoic acid, etebenetsid, vitamins (ascorbic acid, Rutoside, vitamins of group B), antihistamines.
The course of dermatitis Dühring is cyclic, long-lasting, with incomplete short-term remissions; however, in some patients, they show complete independent remissions. On the background of the therapy, the appearance of new lesions is possible, which is not considered an indication for a change in the daily dose of the drug. In most patients, strict adherence to a diet causes a significant improvement , but does not reduce the need for dapsone .