Herpes Dermatitis Is Dangerous?

Duhring - Brocq (DH) is a form of dermatitis, autoimmune dermatitis. This is a lumpy skin disease - blisters, itching, characterized by symmetrical distribution of lesions on the elongated surface such as elbows, knees, buttocks, scalp, nape.
Why get Duhring - Brocq disease?
It is thought that there are a number of factors associated with the disease: Autoimmune body: DH often presents as an autoimmune disease such as glomerulonephritis, Bermeer anemia, thyroiditis, Lupus rash. systemic redness, chronic polycystic inflammation;
Because gluten: gluten is a protein found in cereals (except rice and corn) that is considered an antigen in DH patients.
The component of gluten is gliadin, which binds to reticulin, an important substance in the basilar membrane, which plays a role in increasing adhesion of the basement membrane

. Gliadin also combines with extracellular substances to increase tissue viscosity.
In DH, an increase in extracellular viscosity is associated with the diffusion of fluid in the papillae and leads to the formation of blisters that cause the disease;
Due to fat diarrhea: In patients with DH who have gastrointestinal disease, atrophy of small intestine, but small intestine disease in patients with DH is usually milder than diarrhea; Due to genetics.
Identify the disease
When infected with DH, patients often have mild fever or no fever, fatigue, weight loss, poor appetite In the area where the skin is about to be damaged, there are often signs that itching is followed by burning or pain.




Common lesions are nodules, nodules - blisters or urticaria. Because the itch is heavy, the patient has to scratch, so the skin may feel scratchy and crusted.
The lesions are symmetrical, the most common place is: in the face folded legs, forearms, arms, buttocks, thighs, back and abdomen, less common in the armpits and sacrum. About 4.6% of patients have lesions in the oral mucosa.
At the beginning are erythema, blisters, papules, later bullae, scattered or clustered in clusters. Bullae are as big as corn kernels and contain a lemon-yellow liquid, sometimes with bullous
From 5 to 7 days, the blisters will form pus and break open, leaving behind slits, crusting, pusting pus.



The lesions include many stages, such as erythema, bullae, ulcers, some leave only a dark inlaid. The disease progresses in waves, increasing with decreasing time and stabilizing but then returning.
Some cases last a lifetime but patients still lead a normal working life. However, in some elderly patients may be depleted.
Blood tests showed eosinophilia increased by 10% or more. Positive potassium iodide (KI) test (for patients taking 1g or applied topically 50% KI fat in vaseline to the skin, the reaction appears after 24-48 hours in the form of itchy erythema or itchy bullous rash).
The immunofluorescence test is most valuable for diagnosing DH, with IgA deposition at the top of the papilla with a positive rate of 85-90%.
The diagnosis is based on four typical symptoms: itching of the skin before the appearance of lesions, erythema, papules, blisters, bullae.




Differential diagnosis with a number of diseases: In common pemphigus, the simple lesions are bullous in the epidermis and negative KI test.
Bullous pemphigoid disease is a common disease in the elderly, bullous stretches difficult to burst, if broken, healed quickly, immunofluorescence test directly detects IgG antibody deposition and complement at the basement membrane.
Erythema multiforme is infected with infected cells like in DH. Impetigo is bullae on the skin of inflamed skin, bullae quickly burst, leaving yellowish scales.
Allergic allergic rashes are erythematous, papular, edematous, often itchy but characteristic spots appear quickly and disappear quickly. There are also differentiated with shingles nerve, bullous itchy papules ...

Treatment of disease
The spot treatment mainly used as antiseptic solutions such as millian, methyl purple, methylene blue applied to the lesions. In case of injury, water burns, need to use sterile needle to puncture fluid before applying drug.
For dry lesions can apply chloroxide, flucina grease. In severe cases, patients may be prescribed systemic as follows: corticosteroids 30-40mg / day, then lower the dose gradually in 4 - 8 weeks. Erythromyxin antibiotic orally 1 - 1.5gam / day for 7 days in 2-3 sessions.

Patients respond quickly (only in 1-2 days) with dapson but must monitor closely to avoid complications..

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