What are the Symptoms of Dermatitis Herpetiformis?
Typically, DH can be characterized as an intensely itchy skin eruption distinguished by the formation of small papules or vesicles. The patient may perceive having red bumps and blisters. The symptoms of intense burning, stinging and itching cannot be overemphasized. It is common for DH lesions to be symmetrically distributed on the extensor surfaces of the body: over the elbows, knees, buttocks, scalp, posterior, neck, sacral (lower end of the spinal column) and shoulder areas. The face and facial hairline are occasionally affected. And rarely, the lesions occur within the mouth. Although its severity may vary, it persists indefinitely and is a lifelong condition. There are only a few patients in whom the disease remits for long periods of time.
The lesions may first appear as discolorations and next consist of small bumps called papules and small blisters called vesicles. These lesions tend to occur in groups much like the lesions of Herpes, hence the term herpetiformis, meaning "like Herpes." Because of the intense itching, the lesions are often scratched; these scratched areas will then develop crusts and often then heal with changes in color, either those of hypopigmentation or hyperpigmentation. Most DH patients can usually predict the location of a new lesion as much as 8 to 12 hours before the actual onset because of the symptoms of localized burning and itching. Though the blisters tend to come out in crops, all stages can be seen at any one time. The blisters may take from 7 to 10 days to lose their itching and burning sensations and then begin to crust. They are rarely inflamed and don't contain pus. Although there are recorded cases of the lesions occurring on the lips and within the mouth, it is extremely unusual for lesions to occur on mucous membranes (soft tissues at body openings) in other areas of the body.
The following pictures were provided by MEDLINEplus.
|
|
 |
| Close-up of Lesion |
|
DH on the Knee |
 |
|
 |
| DH on Arm and Legs |
|
DH on the Forearm |
 |
|
 |
| DH on the Hand |
|
DH on the Thumb |
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( www.hon.ch). |
Even though the lesions of DH are unique, they may be confused with many other conditions. However, they can usually be differentiated on the basis of biopsy and immunologic criteria. DH is not a condition for self-diagnosis.
The microscopic findings of DH are characterized by collections of cells called neutrophils in the tips of the dermal papillae (the areas where the dermis or second layer of skin extends up to and near the epidermis). Also, within the dermis and around the blood vessels are many cells called lymphocytes and histiocytes. Eventually, blisters are formed at the junction of the dermis and epidermis.
|
