Duhring disease (dermatitis herpetiformis): What is it? How is it diagnosed?

Duhring disease, also known as dermatitis herpetiformis (it has nothing to do with herpes) or Brocq-During, was first described and named by a Dr. Louis Duhring at the University of Pennsylvania in 1984.

It is a rare, chronic skin disorder. There is no cure.

The disease is characterized by severely itchy blisters and skin lesions which are usually grouped over the elbows, knees, back and buttocks. Palms are soles are spared.

In addition to the extreme itchy sensation, other symptoms of Duhring include burning and stinging. Some patients afflicted by this disorder may have trouble sleeping and may be more susceptible to intestinal lymphoma.

The disorder is more prevalent in people of Northern European ancestry, and males are afflicted more often than females. Usual stage of onset is between the ages of 20 and 45.

It is rare in people of African origin and also quite rare in the Asian population.

Duhring is considered an autoimmune disorder associated with a sensitivity to gluten, and a genetic predisposition has also been demonstrated.

Diagnosis usually involves skin biopsy. The biopsy sample should be taken from the edges of a lesion.

Some practitioners also employ direct immunofluorescence of the lesioned skin. This diagnostic method, however, often gives false negative results.

As I mentioned above, Duhring is much more prevalent among those who have a genetic predisposition to gluten sensitivity.

If you suffer from dermatitis herpetiformis, it may be a good idea to avoid any topical preparations - including creams, lotions, shampoos and hair conditioners - that contain hydrolyzed wheat proteins.

Gluten is a protein. It is found in rye, barley and wheat. Oats and rice belong to different species, and are usually well-tolerated.

Dapsone has been around for many, many years. It is used, in conjunction with other medications, for the treatment of several disorders that affect the skin, notoriously leprosy and Kaposi’s sarcoma.

Dapsone usually brings relief within a couple of days. Its plasma concentration peaks within 8 hours.

Dapsone may cause serious side effects, including blurred vision, anemia, hemolysis (the rapture of blood cells with consequent release of hemoglobin), agranulocytosis (dangerously low levels of white blood cells), and methemoglobinemia , where the body is unable to “recycle” damaged hemoglobin. Please note:

- There are 2 types of methemoglobinemia.

- Methemoglobinemia may be acquired or inherited.

- The risk of agranulocytosis is 25 times higher in people afflicted by Duhring disease (dermatitis herpetiformis) than those with other forms of dermatitis.

Dapsone should not be used for prolonged periods of time.

Unfortunately, many patients will be informed that they'll have

to take it for the rest of their lives...

Be prepared for regular blood testing (see risks mentioned above)while taking this drug.

Duhring disease & other skin disorders