What are the symptoms and manifestations of Durring dermatitis in children and adults: definition, methods of treatment and causes of the manifestation of herpetyform dermatitis of acute form. Herpetyiform dermatitis: symptoms, reasons for the appearance and treatment of herpetiform Durring dermatitis in the floor

Durring's disease, or bullous herpetiform dermatitis, is dermatosis, which is characterized by primary polymorphic rash (true polymorphism), pronounced itching, a feeling of burning, paresthesia and chronic flow with periodic recurrences and remissions.

Prevalence of the disease

The available data of various authors are ambiguous. The number of patients per 100 thousand population ranges from 11.3 to 75.5. And in accordance with the studies of some authors, men are somewhat more often ill, according to other women. Herpetyiform dermatitis Duringe meets mainly in the North European states among the adult population of mostly middle-aged (30-40 years), somewhat less often - among senior people. In children, this pathology is rare enough, but among them about 10% are breast-age children.

Causes and mechanism for the development of pathology

The disease has been known for more than 130 years, but its causes and pathogenesis are still not fully established. In 1966, and in subsequent years, reports began to appear about the identification of celiac disease among many patients with herpetyiform dermatitis. Cellicia, or gluten-sensitive enteropathy, is damage to the Vorsin epithelium of the small intestine by protein gluten or similar to it Gordin, Avenin, and others, contained in the gluten of cereal plants - barley, wheat, rye, oats. This intestinal pathology is often accompanied by symptoms of malabsorption.

Genetic theory

According to the results of the family research conducted, 4-7% of Durring patients with the nearest relatives with the same disease were revealed and a significantly higher percentage - with the presence of relatives suffering from celiac disease. In addition, monosic twins were revealed, one of which is sick of gluten-sensitive enteropathy, and the second - herpetyiform dermatitis.

All these and many other facts served as the basis for the suggestion of genetic nature and similarity between these two pathological conditions. The confirmation is the presence of 90% of such patients in the sixth chromosome of various forms of the same gene, which determine the development of the disease (Durming or Colecia dermatitis).

Autoimmune theory of pathogenesis of herpetyform dermatitis

In the serological examination of the affected areas of the skin using a direct immunofluorescence technique in most patients, fixed immunoglobulin deposits "A" (IgA) are detected at the site of the epidermis compound with a dermal or in the nipple of the skin. Iga is an antibody and is located in the form of granules in the area and inside the derm papillas located near the basal membrane.

These antibodies are directed against the structural components of the papillas of the dermis. In some patients, gluten-iga are found complexes, which are also circulated in the blood. According to various data, there are 30-100% of patients with herpety -iform dermatitis without gastrointestinal symptoms in the mucous membrane of the small intestine, partial or complete atrophy of the patronage of the epithelium mucous membrane is found like celiac disease.

In this regard, the most propagation was the autoimmune theory of pathogenesis of the disease, in accordance with which the mechanism of development of pathology lies in the autoimmune lesion of tissues.

Provoking factors

Thus, it is assumed that the genetic cause of the disease is implemented by an autoimmune mechanism in the presence of provoking factors - background diseases and violations in the body. The main ones are:

1. The use of relatively significant number of flour products and dishes with pearl, semolina and bruises, starch, as part of which contains gluten and similar protein components, as well as increased sensitivity to iodine, iodide preparations and seafood (contain iodine). In this regard, the diet in dermatitis Duringe is the basis of pathogenetic therapy.
2. Allergic reactions to vaccines or / and drug preparations (less often).
3. An autoimmune diseases of the connective tissue.
4. Acute or chronic thyroiditis.
5. Type I diabetes mellitus.
6. Malignant tumors.
7. Blood diseases (lymphoganoomatosis).
8. Physiological changes in the endocrine system (with sexual maturation, pregnancy, menopause).
9. Viral infections, gliste invasions and intricensication of the body.
10. Irradiation with ultraviolet rays and stressful states.

Symptoms dermatitis Duringa

The nature of the flow

The disease begins gradually, it can last over several weeks and even months and accompanied by moderate itching and burning skin, which are precursors. By purchasing a chronic nature of the flow, herpetyiform dermatitis is interrupted by periodic remissions, the duration of which ranges from 3 months to 1 year. Recurrements can last for years.

The beginning is manifested by a moderate increase in temperature and subjective sensations in the form of a general ailment, a decrease in appetite, burning and tingling of the skin.

Description of rash

A true polymorphism due to the combination of different primary (erytimes, nodules, papules, bubbles) of elements with further addition of false polymorphism in the form of a combination of secondary elements (erosions, crusts and exclirations) is characteristic of skin rashes. The appearance of rash is always accompanied by a feeling of burning and intense itch.

Erythematous spots have quite clear rounded outlines and, as a rule, small sizes. If the swelling is developing, they are somewhat towering over healthy skin, and the surface becomes smooth and saturated pink-red.

Then gradually due to the "sweating" of the liquid part of the blood through the walls of the extended vessels on the background of the stains are formed urctural (node) rash. All this externally resembles a gloomy.

Upholstery elements in Durring dermatitis have a tendency to increase in the peripheral direction and merging among themselves, as a result of which large-scale blue-pink foci are formed with clear boundaries having bizarre, festral or (less often) correct rounded outlines. The surface of the foci is covered with separate bubbles (vesicles), serous and bloody crusts and exclirations (traces of combs). The foci themselves are prone to merge with the formation of a rings with a diameter of up to 20-30 mm, arcs, figures with fancy outlines and garlands.

Vesiculi have minor sizes (no more than 2-3 mm). They can appear both on spots, and on the background of a visually healthy skin surface. Bubbles are covered with a dense tire and contain serous fluid. If they are grouped, they resemble rash with a simple herpes. As a result of their drying, a light crust is formed. But more often, gradually, their contents are muttered and as a result of the addition of secondary infection (especially during comb), it is formed with purulent content.

After opening, the erosive surfaces are exposed, not prone to merge, which are covered with a blood circuit and quickly epithelined. If there are rashes in the form of bubbles (Bully), then they are characterized by the same clinical and evolutionary development, as for vesicles, their difference is only in different magnitude achieved in diameter by bubbles 5-20 mm. In the contents of Vesicul and bubbles often from the first days or a few later, a large number of eosinophils are found.

The rashes, mostly wear a symmetrical nature and are localized on the scalp, on the skin of the face and the rear surface of the neck, on the hands and legs (external surface), in the area of \u200b\u200bthe shoulder, elbow and knee joints, on the skin of the lumbly-sacral and berry regions. Uncharacteristic for herpetyiform dermatitis is the defeat of the mucous membranes, but according to individual authors it can be revealed in 50% of patients. In exceptional cases of erythema, vesicles or bulls on the mucous membrane of the oral cavity are subsequently transformed into erosion.

Depending on the predominance of the primary elements of the rash, the following main forms of dermatosis are conditionally distinguished:

• papulse;
• uRTIODOUS;
• vesiculous;
• pustular.

After the permission of the rash in its place, peeling occurs, gradually disappearing sites of hyperpigmentation or depigmentation.

Diagnostics

The diagnosis is established on the basis of:

• data Anamnese Disease - the presence of close relatives with Durring dermatitis or celiac disease, the development of the disease or its exacerbation after receiving gluten or iodine-containing products or drugs;
• the character of the rash is true and false polymorphism, the specificity of localization, symmetry, a tendency to merge and grouping elements;
• severe itching and burning, accompanying rashes;
• presence of eosinophilia in the blood and / or liquid bubbles; At the same time, its absence does not exclude pathology;
• the positive sample of the Yadasson, which is applied to 1 day of 50% ointment of iodide potassium on the skin of the forearm in the form of a compress;
• data histological research - the presence of bubbles under the epidermis with significant clusters of eosinophils and neutrophils on the top of the dermal papillars, extended dermal blood vessels; The latter are surrounded by infiltrates consisting of strokes of eosinophils and fragments of destroyed nuclei ("nuclear dust") with neutrophilic leukocytes;
• identifying in the region of basal membrane IgA (when conducting a direct immunofluorescence reaction).

Features of clinical current in children

For most children, Durring dermatitis develops after the infectious disease. The beginning of the disease, as a rule, is acute with a temperature rising within a week to 39 °, and pronounced symptoms of general intoxication - intensity or, on the contrary, excitation, lethargy and the absence of appetite.

On the head, neck, torso (spin, the front surface of the chest, the area of \u200b\u200bthe abdomen, buttocks), on the skin of the limbs (with the exception of palm and plantar surfaces) symmetrically arise the foci of the edema, against the background of which other types of raishes appear quickly. Especially frequently rashes are localized in the field of external genital organs and in large skin folds.

Bullese herpetyiform dermatitis is characterized by larger than in adults, elements, more frequent by their suppuration and localization on the mucous membranes of the oral cavity, as well as a more rare content of an increased amount of eosinophils in the contents of bubbles. Children have the prevalence of common forms of localization of the rash with the development of polyadenitis (increasing multiple lymph nodes), but less leaning to grouping and merging elements. How to treat the disease?

Treatment of herpetyiform dermatitis Durin

The complex method of treatment includes the recommendation of the diet, which provides for a limitation or exception (during recurrence periods) of the above-mentioned foods, as well as cabbage, legumes, beans, bread kvass, beer, cooking salt, seafood, sausage, chocolate, ice cream. Dishes are recommended using rice, buckwheat, corn, consumption of increased quantity of fruit, from drinks - black and green tea, natural coffee, low iodine and bromine mineral water.

Treatment of Durring Durming by folk remedies includes mainly external means that contribute to the reduction of itching and inflammatory processes - baths with the Victims of the Zverkoy, flowers and leaves of Barwinka, herbs, calendula, tricolor violets, with a decoction of licorice root and others. For skin treatment , oils and ointments with the content of extracts of the same plants.

Of the medicinal products, the preparations of sulfonic series are most effective (dapson, diaphenylsulfone, DDS, Assulophone, Sulfapyridine, Diucifi Phone, etc.) according to a certain scheme as medicinal monotherapy. In cases of a protracted or severe course, they are combined with glucocorticosteroids.

Herpetyiform Durring dermatitis is a chronic recurrent disease of the skin of unexplained etiology. Presumably dermatitis has an autoimmune nature. Factors that can provoke dermatosis development:

• weakened immunity;
• the intolerance of gluten - protein, which is contained in the cereals;
• allergic reaction to iodine-containing products;
• genetic predisposition;
• disorder of the gastrointestinal tract;
• increasing the level of monasterkers;
• the presence of glitne invasion;
• mental overload and stress;
• hormonal failures of the endocrine system;

The disease occurs in 0.19-1.4% of cases from all skin diseases at any age (more often in men in 25-40 years). It is characterized by remissions of various durations from a couple of months to a year or more. The beginning of the disease can manifest itself with general weakness, subfebrile temperature. The main sign of dermatitis - rash on the skin, which are visually similar to herpes. The rash is characterized by a true polymorphism (combination of various elements): erythematous spots, papules, vesicles, urctic-like efflorescence, bubbles, pustules. Often, one of the elements prevails.
Therefore, depending on the main element of the rash, the following clinical forms of Duringe dermatitis are distinguished: vesiculous, urctic acid, papular, bullous. Erythematous stains round shape and with clear outlines. Their smooth surface is covered with bloody and serous crusts. Next, they are seeping with extended blood vessels and transfer to urctic-like efflorescence. Dermatosis can develop without erythematous spots. The elements of low-size rashes (in diameter up to 2 cm) - vesicles, more than 2 cm - bullous bubbles. The exhaustion is localized on any part of the skin, more often on the extensive surfaces of the limbs, elbows, neck, face, back, buttocks, mostly symmetrical. Vesicul and bubbles are dense tire and transparent content in which there can be a small content of blood. If the content of bubbles is muttered, this indicates the attachment of the infectious process. Over time, true polymorphism is combined with false. When drying the contents of bubbles, a crust is formed. During combing, it is revealed, and erosion with fetestal outlines remains in her place. The mucous membranes are usually not activated in the pathological process. When healing rams on the skin, hypo-or hyperpigmentation remains, less as scars. The extension is accompanied by a strong itching and burning, parstisians, common malaise.

In children, herpetyiform dermatitis Durring flows in a more severe form than in adults, mucous membranes are often involved in the pathological process. Among the elements of rashes are dominated by vesiculous, polymorphism and herpetyformality are poorly pronounced.

Diagnostics

The diagnosis is carried out by a dermatologist based on clinical symptoms, histological studies of affected areas of skin, laboratory and instrumental research:

• With histological examination of inflammatory skin sections, the cavity with infiltrate under the epidermis is characterized, in infiltrate are determined in large quantities of accumulation of neutrophils, eosinophils and the remains of their destroyed nuclei. Bubbles are outlined by papillary micro-passages, which are located on the tops of the dermal packers.
• Increase in blood and infiltrate bubbles of the number of eosinophils.
• Violation of the work of the shield-like gland.

Sandy of Yadasson:

• Corger sample with iodine. The forearm area impose a special compress with ointment, which contains 50% of potassium iodide for 24 hours. After that, the compress is removed, and evaluate the reaction. The presence of redness and rashes at the site of the compression imposition indicates a positive sample. In the case of a negative sample, after 48 hours it must be reused.

• Reception inside 2 tablespoons of 3-5% solution of potassium iodide. With severe disease, such a sample is not recommended.

Straight immunofluorescence shows the accumulation of fixed immunoglobulins A on the surface of the dermal papillas.

Treatment of herpetyiform dermatitis Durin

A gluten-free diet that excludes cereal from the diet: wheat, oats, rye, millet, barley. In addition to cereals, it is not recommended to use products containing iodine (sea fish and cabbage). Treatment with medicines is carried out by the preparations of sulfonic group: a diaphenylsulfonic (Austulophon, Dapson), sulfasalazine, diucifon, solidfone. These drugs are prescribed to a parenteral course for 5-6 days with a break in 1-3 days. The number of such therapeutic courses is determined by the severity and clinical form of the disease and the effectiveness of treatment. With ineffective therapy with sulfones, used in medium doses of glucocorticosteroids (prednisolone, methylpredinisal, dexamethasone). To reduce itching, burning and allergic reactions, antihistamines are shown: Dezloratadine, Supratine, Erius, Eden. Local Therapy Durmatosis Durring implies the adoption of warm baths with a weak manganese solution, opening bubbles and their processing by aniline dyes, a solution of diamond green or fuarcin, overlapping for inflammatory areas of skin bandages with corticosteroid ointments or sprays, compress with 5% dermatol ointment.

Folk methods for treating Durring dermatitis

• Infusion on medicinal herbs. Mix in an equal number of licorice root, Highlander bird, Speert, violet tricolor, sea buckthorn, calendula flowers, juniper. The resulting blend of herbs pour into one liter of steep boiling water and insist two hours. Liquid strain and eat daily 2 times a day on a tablespoon before meals for 2 months.
• Homemade healing ointment. Paul pork fat kilograms melt in a water bath. Finely cut 1 piece of handles and combine with 2 parts of swine fat. Throw the resulting mixture in the oven at a temperature of 90 ° C is about half an hour. Profiltrate the mixture and daily lubricate the healing oil on the skin.
• Alcohol tincture on medicinal herbs. In equal parts to mix juniper, nettle, pyrhem, calendula flowers. Pour the herbal collection of 0.5 liters of vodka. The resulting tincture is in a dark and cool place for 10 days. The tincture is filtered and wiped with it affected foci on the skin every day.
• An oil from the Hypericum. Mix 200 ml of sunflower oil and 30 grams of crushed grass of the Hypericum (flowers and leaves) and withstand in a dark place for about two weeks. Profiltrate and apply oil to inflamed foci daily.
• Ointment from the Hypericum. Freshly squeezed juice from a drilling in a water bath before thickening. To one part of the thickened juice add 4 pieces of butter and mix thoroughly to uniformity. The resulting ointment is applied to the affected areas.
• Birch kidney decoction. Take 1 cup of birch kidney to pour the glass of water and peel on low heat for 20 minutes. Decoration cool and filter. Such a decoction wipe the hatching on the skin.
• Tea with Melissa. When used instead of black tea with brewed fresh or dried grass Melissa, you can extend the periods of remission.

Chronic recurrent skin lesion, manifested by polymorphic rash in the form of erythematous spots, bubbles, papules, blisters and accompanied by pronounced itching and burning. The disease got its name due to the fact that the elements of the rash during Durring dermatitis are grouped in the same way as rashes during herpes. Diagnosis is carried out with the help of histological research, analysis of the contents of bubbles and the reaction of direct immunofluorescence. In the treatment of herpetyiform dermatitis Duringa, a sulfonic group of drugs and corticosteroids is effective.

General

Herpetyiform Durring dermatitis occurs at any age, but most often it develops at 30-40 years. Men are more susceptible to this disease than women. In some cases, herpetyiform Durming dermatitis is a skin reaction to a malignant tumor of internal organs existing in the body, that is, acts as parabonoscological dermatosis.

Causes of occurrence

The causes and mechanism of the development of herpetyiform dermatitis Duringe are unknown. In many patients, the intolerance to the glutin protein contained in cereal plants is revealed. In favor of the autoimmune component in the development of the disease, the detection of IGA antibodies on the border of the dermis and the epidermis is in the region of the basement membrane. It is assumed that increased iodine sensitivity, heredity, ascaridosis, inflammatory processes of the gastrointestinal tract (gastritis, ulcerative disease), viral diseases (Gastritis, ulcerative disease), viral diseases (ORVI, Herpety infection, etc.) play a certain role in the occurrence of herpetiform dermatitis Durin.

Symptoms

Typically, the herpetiform dermatitis Durring has an acute start with the advent of the foci of polymorphic rash. The rashes may be preceded by a moderate body temperature, general weakness, itching and a feeling of tingling. The elements of the rash can occur on any section of the skin, except soles and palms. But the most frequent location is the extensive surfaces of the hands and feet, the area of \u200b\u200bthe blades, shoulders, loins and buttocks. Petechia and ekkimosis can occur on the palms - large (more than 3mm) stains of intradermal hemorrhages. The rashes are accompanied by pronounced discomfort: a feeling of burning, intense itching and paresthesias. The lesion of the mucous membranes during herpetiform dermatitis Duringe is usually absent. In rare cases, bubbles can occur in the oral cavity, quickly turning into erosion.

The true polymorphism of the rape in herpetyiform dermatitis Duringa is associated with the simultaneous appearance on the skin of various sizes of erythematous spots, blisters, papules and bubbles. Over time, the true polymorphism is attached to the true polymorphism: they are formed by the transformation of erosion and crusts associated with the transformation, as well as caused by the strong combination of the skin of the excoriation. When healing the elements of rash on the skin, the foci of hypo- and hyperpigmentation remains, sometimes scars.

Erythematous spots under herpetyiform dermatitis Durring have a clear contour and rounded shape. Their smooth surface is often covered with breaks, bloody and serous crusts. Over time, they are soaked with extended vessels and turn into similar to the Voldari (Ultra-like) education. The latter grow along the periphery and merge, transforming into pink-blue foci, covered with crusts, bumps and bubbles. Along with this, erythematous spots can go to juicy pink-red papulas. In addition, the occurrence of papules and urctic-like rashes can occur without stage of erythematous spots.

Bubble elements of rash during herpetyiform dermatitis Duringe can be of a small size - vesicles and a diameter of more than 2 cm - bullous rashes. They are filled with a transparent liquid, whose turbidity speaks of the attachment of infection. Bubbles are opened and dried with a crust. Due to combing, the peel is removed and erosion remains on the site of the bubble.

Depending on the prevalence of one or another type of rash over the rest, the following types of herpes dermatitis Duringe are distinguished: Papulous, vesiculous, bullous and urctic-like. Atypical diseases of the disease are possible: tricophytoid, eczemonoid, journaloids, etc.

The sharp periods of herpetyiform dermatitis Duringe are combined with rather long remissions (from several months to a year or more). The exacerbations often flow with a deterioration in the overall condition of the patient, the temperature rise, sleep disorders.

Diagnostics

With suspected herpesiform dermatitis Duringa, Yadasson's iodine sample is carried out. A healthy piece of leather is superimposed compress with an ointment containing 50% of potassium iodide. After 24 hours, the compress is removed. The identification of redness in its place, Vesikul or Papul speaks in favor of Herpetyform Durring dermatitis. If the sample is negative, it is repeated. For this, after 48 hours, they impose the same compress on the area of \u200b\u200bpigmentation remaining after the former rashes. The sample of the Yadass can be carried out with the reception of the drug of iodine inside. But such a study is fraught with a sharp exacerbation of the disease.

In herpetiform dermatitis Durring in clinical analysis of blood, an increased content of eosinophils is found. With cytological examination of the contents of bubbles, a large number of eosinophils are also detected. However, these data, as well as the sample of the Yadasson, are not mandatory or strictly specific to the disease.

The most reliable way to diagnose herpetyiform dermatitis Duringe is the histological examination of areas of affected skin. It reveals the cavity located under the epidermis, the accumulation of eosinophils, neutrophils and residues of their destroyed nuclei. The reaction of direct immunofluorescence (reef) detects on the tops of the derm papillars of the deposit of the IGA.Dermatologist. Assign a diet, excluding cereals and iodine-containing products (sea fish, seafood, salad, etc.). Drug therapy is carried out by sulfonic group preparations: diaphenylsulfophone, sulfasalazine, solidfone and others. These drugs are usually prescribed inside cycles of 5-6 days with interruptions of 1-3 days. In cases of ineffectiveness of sulfonic therapy, treatment is carried out by medium doses of corticosteroids (prednisolone, dexamethasone, etc.) to relieve itching, antihistamines are used: Loratadine, Cetirizin, Disloratadine.

Local treatment of herpety -iform dermatitis Durring includes warm baths with a solution of manganese, opening bubbles and their treatment with greenflaw or fuccin, the imposition of corticosteroid ointments or aerosols, the use of 5% dermatol ointment.

Durring dermatitis is a skin disease, the exact reason for the appearance of which was still not possible to determine. On the epithelium, it is manifested in the form of itchy rash, which covers the body, limbs. We will talk today about the symptoms of the disease, the causes, methods of diagnosing and treating the herpetiform dermatitis Durring in children and adults, we describe the diet, consider the photo of patients.

Features of the disease

On the epithelium, it is manifested in the form of itchy rash, which covers the body, limbs.

• The risk group consists of 15-60 years.
• Representatives of strong sex more often suffer from this ailment.

About the species that Herpenetiform Durring dermatitis in childhood and old age will tell below.

Forms

Herpetyiform Durring dermatitis has several forms. They are distinguished according to which of the types of rash prevails.

The disease distinguish such types:

• ultra-like;
• vesiculous;
• papular.

A specialist in this video will tell more about Durmatite Durring:

Causes of occurrence

Ethiology, the pathogenesis of this disease is still not clarified. Experts believe that it has an autoimmune nature. In the basal membrane (on the border of the dermis, epidermis), the researchers discovered IGA antibodies.

A significant role in the manifestation of the disease under consideration of high sensitivity to the drugs of iodine was noted. When conducting an experiment, the patient was administered inside the iodide solution (3-5%). After the administration of the drug, the appearance of a rash, which is typical of the species under consideration of the skin disease, was noted.

In a large number of patients, the doctors discovered the intolerance to the gluten protein, which contains cereals.

Among possible reasons are considered as follows:

• heredity;
• diseases of the gastrointestinal tract (ulcers, gastritis);
• diseases with viral etiology (, ORVI);
• ascaridosis.

Symptoms

The disease begins acutely with the formation of foci of polymorphic rash. At the beginning of the illness of the patient, the following its manifestations are disturbing:

• red spots;
• blister;
• bubbles;
• round-shaped bubbles.

Blister initially contains a transparent liquid. The contents of the bubble then becomes muddy. Bulk fluid, which is inside the bubble, indicates the attachment of any infection. Blister tire dense. Over time, blisters can go into ulcers, after opening, they turn into ulcers. Around the ulcerations are bubbles tires. Crusts appear on top of the ulcers that indicate wound healing.

Localization rash

• face;
• forearm;
• elbows.

Less often illness affects such areas:

• slaughter;
• knees;
• sacrum;
• buttocks.

On the palms, footsteps usually do not appear. Outdoor hemorrhages may appear on the palms. The dimensions of such petechs, ekkimosis can reach 3 mm. The disease does not affect mucous membranes, only occasionally bubbles can appear in the oral cavity. They are very quickly becoming erosions.

Uncomfortable signs

The patient has discomfort such symptoms:

• burning;
• deterioration of the general condition;
• combing.

Medication

In the therapy, Durring dermatitis use the preparations of the sulfonic group. These include:

• sulfapyridine;
• diucifon;
• diaphenylsulfon.

The above preparations are taken inside for 5-6 days, then take a break in 1-3 days. Cyclic treatment is considered very effective.

If the therapy with sulfonic means did not bring improvements, attributed to the average doses of corticosteroids:

To cope with the boring itch, use such antihistamine drugs:

• "Erius."
• "Zirtek".
• "Claritin".

For local treatment, a greenhead solution, furcin, dermatol ointment (5%), anti-inflammatory sprays, corticosteroid ointments are used.

There is a Durming dermatitis in treating folk remedies, tell me below.

Folk methods

You can also use folk methods to accelerate the healing of combs, reduce the intensity of itching, to eliminate pain. Before using home treatment methods, it is recommended to consult with a dermatologist.

Among the multiple recipes of traditional medicine are effective in the fight against Durring dermatitis are the following:

1. Infusion of herbs. For its preparation, the following components will be required, which are taken at 1 tbsp. A spoon: licorice root, degrees, berries sea buckthorn, calendula, violet is a tricolor, juniper, hustlese bird. All components pour a liter of boiling water. After insisting within two hours, the means is ready. It is taken before meals on a tablespoon. Drink tool need 2 times / day.
2. Tincture on herbs. For its preparation, such ingredients are needed, in the amount of 1 tbsp. The spoon of each: juniper, pyrhem, nettle, calendula, yarrow. Everything is poured with 0.5 liters of vodka. After insisting within 10 days in a dark place, the device is ready. They wipe the hit epithelium.
3. Ointment. For her preparation, it is necessary for interior pork fat, the grass is shy. Heat fat in the oven (2 parts), grind grass (1 part), mix everything. Mass need to tomatize in the oven at a temperature of 900c. Then it is filled with, the means lubricate the hit epithelium daily.

Diet

So, what can not be with Durring Dormatite? A feature of therapy is considered a mandatory diet at which it is prohibited:

• cereals and legumes
• food with flour and malt,
• kvass, beer and coffee substitutes,
• chocolates and ice cream,
• flour products and products in breading,
• sausages
• iodine-containing products.

Note! Cabbage when Durring Durmatite is also prohibited.

In more detail about diets in Dermatitis, this video will tell:

Prevention of the disease

Durming dermatitis refer to chronic diseases. Recurrements can occur throughout the life of the patient.

To avoid relapses, complications follow the recommendations of the dermatologist. Preventive measures include:

1. Tracking the diet. You need to exclude iodine-containing products (seafood, walnut, medicines containing iodine), cereals (rye, oats, wheat, barley).
2. To be on dispensary observation, regularly undergo surveys.

Complications

The only complication that may arise is to attach a secondary infection.

Forecast

The disease occurs cyclically. For most patients, there is a favorable forecast. But for this you need to comply with the recommendations of the specialist, comply with the diet.

The difference between dermatitis, dermatosis and diathesis will tell the doctor in the video below:

Detailed article on the causes and main manifestations of Durring dermatitis, diagnosis and methods of treatment.

Herpetyiform Durring dermatitis: Early diagnosis and treatment

Durring dermatitis is an inflammatory skin disease caused by a disorder of gluten in the intestine (gluten enteropathy).

Being a benign process, it takes chronically with periodic exacerbations.

Herpetyiform Durring dermatitis: Causes of manifestation

The beginning of the disease usually falls at age after 30 years, meeting more often in men.

The main cause of Durring dermatitis is considered to be a violation of genes responsible for the absorption of gluten from food. The skin rash and the use of such products are associated as follows:

• As a result of complex immune processes, the body begins to take its own cells and enzymes as alien and distinguishes antibodies against them.
• Antibodies are damaged both cells of the intestinal mucosa, and through blood vessels reached the basal cells of the dermis containing similar receptors.
• The skin develops inflammation, leading to the delay of the epidermis and the appearance of bubbles.

Other processes in the gastrointestinal tract of the inflammatory nature can also serve as possible reasons, leading to the development of autoimmune reactions.

Some scientists are assumed to be an allergic theory of dermatitis due to a pronounced reaction to iodine. The proof provides the fact that all diseases suffering from pathology in response to contact with him develops an aggravation.

There is a theory about the paranoplastic origin of the disease, that is, the symptoms of a developing malignant tumor, but not recognized confirmations of this.

Some patients' rash manifestation in some patients after infections (ARVI, windshow) suggests the virus nature of dermatitis.

Symptoms and manifestation

The development of the disease can flow 2 scenarios: sharply and with severe symptoms or gradually with increasing clinical manifestations.

Localization of rash:

• upper shoulder belt;
• outdoor side of the forearm and elbows;
• sip of head;
• buttocks;
• knees;
• shin.

On the affected skin, polymorphic elements are visible, from the beginning of the red stains represented, slightly towering over the skin, blisters. Then there are dense bubbles with transparent content grouped in one area. In the place of burst bubbles appear erosion, leaving after healing with hyperpigmentation.

On the prevailing elements, the dermatitis is sometimes divided into clinical forms:

• herpes-like;
• bullous;
• trichofitoid;
• stroofolese.

It is subjectively felt by the title burning, but the general condition and ability to be disappeared.

In children, the disease often appears sharply with a deterioration in general well-being, an increase in temperature, bloating, an increase in lymph nodes.

People with Durring dermatitis hypersensibination to Yesod. If you apply it to the skin or drink in the potassium iodide, then the development of exacerbation is possible.

How diagnosed

Herpetyiform dermatitis is established by a dermatologist on the basis of a survey, inspection and additional analyzes.

Criteria confirming the diagnosis:

1. A large amount of eosinophils in the cytological analysis of the contents of bubbles.
2. Positive test of the Yadasson: 50% of the potassium iodide ointment is applied to a small piece of skin of the wrist, closed with a bandage and left for 24 hours. After a day, the result is assessed by the doctor: if there are rashes and inflammation at the place of application, then the sample is considered a positive characteristic of Durring dermatitis.
3. Antibodies Ig A in the papillas of the dermis according to the results of the biopsy of the skin and the immunofluorescence reaction.
4. Specific skin changes according to the results of histological examination (the presence of fibrin, eosinophils, the location of the cavity under the epidermis), which makes it possible to distinguish Durring dermatitis from other bubble dermatoses.
5. According to IFA blood, IGA antibodies are found to tissue transglutaminase and endomise.

Consultation may be required in other doctors to detect gluutenasted enteropathy.

Also, due to the possible association with malignant neoplasms, especially in adulthood, an in-depth examination of all organs with the help of an ultrasound, mammography, pulmonary X-ray in the relevant specialists is carried out.

Treatment in children

Children's dermatitis Duringe is less common than in adults, the treatment is adjusted according to the child's mass.

Treatment is carried out only by appointing a doctor and under its control.

The drug dapson is prescribed inside in a daily dose of 2 mg per 1 kg of weight.

Applied local medicines

In children's practice allowed to use:

• methylene blue solution, fuccin on erosion or over bubbles, without opening them, applied twice a day;
• a weak solution of potassium permanganate is carefully added to the bath when bathing;
• 1% hydrocortisone ointment is applied in a minimum number twice per day only on the affected areas.

Medicines for gasts

If the Durring dermatitis is suspected, a thorough examination of the gastrointestinal tract to identify possible concomitant diseases is carried out.

Initially in childhood, the disease can manifest themselves pain in the abdomen and bloating caused by inflammation of the intestinal walls.

The treatment is prescribed symptomatic (but-shpa, espeamizan) before diagnosis.

When detecting celiac disease, a strict diet is prescribed, the treatment is controlled together with the gastroenterologist.

Adult Treatment: Scheme

Before starting treatment, blood and urine tests are rented for further observation of the condition of the liver and kidneys.

The first is prescribed the drug Dapson at a dose of 1 mg per kg of weight per day. It is accepted 5 days a week, the next 2 days takes place. The treatment continues up to 1 - 2 years until a long positive effect of the diet appears.

If side effects appear from Dapson, further treatment is carried out by sulfasalazine at a dose of 1 - 2 g per day.

Periodic control of laboratory analyzes is carried out for the timely detection of adverse reactions from the liver and kidney.

Antihistamine preparations are accepted to relieve itch:

• Suprastin tablets 25 mg 2 times a day.
• Loratadine Tablets 10 mg 1 time per day.
• Cetirizin pills 10 mg 1 time per day.

It is necessary to change the active ingredient every 10 days, as addiction is gradually developing, and the effect of weakens.

In addition to drug treatment, the main task is to comply with a special gluten-free diet. The absence of provoking immune reactions of substances in food leads to the disappearance of rashes, on average, after 1 to 2 years.

Strict diet prohibits eating:

• All cereals containing gluten (Oats, wheat, rye, barley), solid, flour products.
• All products made with the addition of flour, malt (pasta, kvass).
• Cabbage, legumes (peas, beans, lentils).
• Sausages and semi-finished products prepared with the addition of fillers from bread or breadcrumbs.
• Sea products with high iodine (red fish, sea salt).
• Sweets (puddings, ice cream).

Locally, glucocorticosteroid drugs in the form of ointment or spray (acrider, feloderm, oxycort) are applied to the weakening of the pronounced itching, 2 times a day for 10-14 days. Bubbles and erosion are processed by aniline dyes (fuccin, aqueous solution of methylene blue) to prevent secondary infection and acceleration of healing.

Prevention

True gluten enteropathy is rarely found, and herpesiform dermatitis develops in 5% of such patients, therefore a gluten-free diet is shown only to people with a prescribed and confirmed diagnosis.

Prevention of exacerbations of dermatitis Durring is reduced to the observance of a diet and a healthy lifestyle.

It should be avoided during the remission of recreation on the sea coasts, protect the skin in the summer from the Sun sunscreen.

Possible complications

In case of non-time, the appearance of complications in the form of attachment of a bacterial skin infection is possible. In places of lesion, hennaments are developing, the contents of bubbles turbines. In this case, antibacterial drugs on the skin or inside are added to the treatment.

Herpetyiform Durring dermatitis is a rare disease, but requiring a long and not simple treatment. It is possible to achieve a long-term remission only a thorough observance of all prescriptions of the doctor.

Useful video