Dermatitis Duhring: what tools are most effective for treatment?
Dear readers, today I will talk about severe skin diseases, whose origin is associated with impaired immune status, we will focus on dermatitis during.
The disease is a chronic recurrent pathology, which is accompanied by a polymorphic rash, often symmetrically arranged. Of the subjective feelings expressed by itching, burning and paresthesia.
The exact cause is still not identified, but the main role is given to the gluten component of cereal, and Halogens.
There are also cases of dermatitis on the background hormonal status (pregnancy, menopause), and disease: toxemia, chronic fatigue, Hodgkin’s disease, nervous exhaustion.
Recently researchers have linked the disease with autoimmune attack IgA, against some component of the papillae of the skin near the basal membrane.
The influence of exogenous allergens, so dermatitis refers to immune pathologies.
The clinical picture
The disease usually manifests in age from 25 to 55 years. It affects mostly men.
On the skin of the patient almost simultaneously or with a slight interval there appear such elements (polymorphism of the rash): bubbles and blisters, pustules and papules, a little earlier on erythematous areas appear blisters.
The primary elements are replaced by secondary: erosion, crust, flakes.
Dermatitis Duhring is called herpetiformis sgruppirovany due to the rash resembling such herpes.
Is symmetrical rash that is both chronic and relapsing course. The characteristic severity of subjective symptoms: itching, paresthesia and burning.
Localization of rash extensor surfaces of the extremities, buttocks, shoulders, lower back, face, scalp.
Along with the changes in the skin, there are eruptions on the mucous membranes of the oral cavity, but isolated they are not.
Mucous membranes are swollen, congested, against this background, visible bubbles, blisters and papules.
After 3-4 days the primary elements are revealed, leaving erosion, the edges of which are scalloped. These changes persist for 2-3 weeks. After recovering in their place remain spots (Hyper — or hypopigmentation).
For cyclic, periods of remission occur for different periods of time.
How to get rid of?
To begin adequate treatment of the disease, you need to spend quality diagnosis. The clinical picture suggests a doctor for a diagnosis and confirm it by analyzing the number of cells called eosinophils in the blood and in the cystic fluid.
In favor of dermatitis Duhring shows increased number of cells in one of the samples. But it is worth considering that the absence of eosinophilia does not give the right to remove this diagnosis.
Test with iodine to determine the diagnosis applicable in two versions: inside and cutaneous. For 24 hours under the compress on the skin of the forearm impose the ointment containing 50% potassium iodide. The area of skin under the action of the drug should not be more than 1 square centimeter
A positive result is the presence of bubbles, papules after removal of the dressing.
If there are no changes, then the patient is given inside 2 to 3 tablespoons of potassium iodide in a concentration of 3-5%.
A positive result with the appearance of all symptoms of exacerbation. In severe cases, it is not recommended to carry out such studies to avoid complications.
All patients should be taken on account and regularly examined for the presence of gastrointestinal disease, the local infectious processes, cancer, especially the elderly, with atypical forms of the disease.
In the first place in treatment costs with the exception of diet products containing iodine and gluten-free.
Were the most effective means of sulfonic row: Diutsifon, diafenilsulfon, Sulfapiridin.
Dose Diafenilsulfona and Diutsifon of 0.05 — 0.1 g twice a day. The treatment cycle should be 5-6 days, in between breaks of 1-3 days.
In General, the treatment course depends on tolerability and efficacy.
When expressed clinical forms or resistance to drugs sulfonic series, parallel prescribe corticosteroids in the average daily dose.
Local therapy is the disinfection. For this patient do baths with potassium permanganate.
Primary elements (bubbles and bubbles) subject to autopsy, the treatment with aqueous solutions of aniline dyes, fukortsin.
Also dermatology topically applied ointment, ointments based on corticosteroids and similar aerosols.
Alternative drugs: sulfapyridine, anti-malarial (less efficiency).
Most cases respond well to treatment. In children sometimes marked tendency to recovery.
But in General the disease is chronic in nature, so for patients who are registered, it is important to follow a diet to prolong remission and reduce the frequency of exacerbations.
I recommend to view the video where the dermatologist very details about this disease:
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