Dermatitis herpetiformis

ডার্মাটাইটিস হার্পেটিফর্মিস (DH) তখনই দেখা দেয়, যখন শরীরের রোগ প্রতিরোধ ব্যবস্থা গ্লুটেনের বিরুদ্ধে প্রতিক্রিয়া দেখায়। গ্লুটেন হলো এক ধরনের প্রোটিন, যা গম, বার্লি ও রাই-এর মধ্যে থাকে। এই রোগে আক্রান্ত ব্যক্তিদের ক্ষেত্রে সেই প্রতিক্রিয়ার ফলেই ত্বকে র্যাশ দেখা দেয়।

A diagnosis of DH is confirmed with a skin biopsy, a test where a small sample of skin is taken and examined. Because DH is so closely linked with coeliac disease, you may also have blood tests done for that condition.

What happens during a skin biopsy test?

For this test, a dermatologist (a specialist skin doctor) takes a small sample of skin from an area that does not have the rash. Skin taken from a rash-affected area does not always give an accurate result.

The sample is then examined. If it shows DH, you will be referred to a gastroenterologist (a specialist gut doctor) to be tested for coeliac disease.

Diet before and during diagnosis

To make sure the skin test gives an accurate result the first time, it is important to keep eating gluten containing foods both before and during diagnosis.

If you have already cut gluten from your diet, you will need to start eating it again, in more than one meal a day, for at least 6 weeks before the tests are done.

Treating dermatitis herpetiformis (DH)

The treatment for DH is a lifelong gluten-free diet.

A gluten-free diet is when all gluten-containing foods are removed from your diet

Gluten is found in wheat, barley and rye and sometimes people are sensitive to oats too.

A gluten free diet should only start once the diagnosis of DH is given and a referral to a dietitian has been made.

Find out how to live with a gluten-free diet

How long does treatment take to work?

The length of time it takes for the skin to heal varies from person to person but it can take up to 2 years or more.

Medication during treatment

Some patients will be given medication to help them over this period of recovery.

Medication will only be given to control the skin itching and blisters and doesn’t treat any other symptoms.

The drug most likely to be used is called Dapsone.

Dapsone

Dapsone is taken in tablet form and must be swallowed.

It helps ease the itching and controls the development of blisters. It should work within a few days.

If you stop taking Dapsone before the gluten-free diet has taken effect, the rash will return.

Side effects of Dapsone

The most common side effect of Dapsone is anaemia.

Less common side effects are headaches and depression, while nerve damage is rare.

You’ll always be prescribed the lowest effective dose to help prevent these side effects.

DH should be monitored once the drug dose has been reduced.

Alternatives to Dapsone

Some people can’t tolerate Dapsone. If you’re one of these people, the following drugs can also be taken to clear the rash:

• Sulphapyridine
• Sulphamethoxypyridazine

DH can lead to the same complications seen in coeliac disease. These may include weaker bones (osteoporosis), certain gut cancers, and a higher chance of other autoimmune conditions like type 1 diabetes and thyroid disease. Just as with coeliac disease, staying on a gluten-free diet lowers the risk of these problems developing.