DERMATITIS HERPETIFORMIS |
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DESCRIPTIONDermatitis herpetiformis is a chronic skin inflammation characterized by clusters of small itching blisters. The disorder is hereditary. It is not contagious or cancerous. The skin of the elbows, knees, shoulders, arms, legs, and over the bottom of the spine (sacrum) is involved. Dermatitis herpetiformis can affect both sexes, beginning at puberty.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
SIGNS & SYMPTOMS
Lesions with the following characteristics:
Lesions are small clusters of 5 to 20 blisters. Blisters usually measure 2mm to 6mm in diameter.
Clusters appear on both sides of the body in the same places.
Lesions itch, but they are not usually painful if there are no complications.
CAUSES
Unknown, but it may be a disorder of the autoimmune system.
RISK FACTORS
Exposure to heat and humidity.
PREVENTING COMPLICATIONS OR RECURRENCECannot be prevented at present. To prevent a recurrence of symptoms, your child should continue to take medication as directed and prevent injury to normal skin.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Biopsy (See Glossary).
POSSIBLE COMPLICATIONSChildren with dermatitis herpetiformis also may have disease of the small bowel (without symptoms), which pathologically resembles that of patients who are intolerant to gluten. The only way to diagnose this is with a biopsy.
PROBABLE OUTCOME
This is a chronic disease. Treatment can control your child's symptoms--including itching -- but it will not cure the disease.
TREATMENT
HOME CAREYour child can soak in cool water or use cool-water compresses to reduce itching.
MEDICATION
For the child's itching, use non-prescription drugs such as:
-- Low-dose steroid lotion, ointment, and cream. These reduce inflammation and itching in 24 to 48 hours.
-- Topical anesthetics and topical antihistamines. These provide quick, short-term
relief. Many cause skin sensitivity, but lidocaine and pramoxine usually do not.
-- Lotions containing phenol, menthol, and camphor (such as calamine lotion). These are soothing, but use with care. Large amounts may be absorbed through the child's skin into the bloodstream, and they can be toxic.
To control blistering, your doctor may prescribe 2 oral medications, sulfapyridine or dapsone. If either one is needed, it will be required indefinitely.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions, except your child should avoid overheating and moisture.
DIET & FLUIDS
Restricting gluten in the child's diet will reduce the amount of medicine needed.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your child has symptoms of dermatitis herpetiformis.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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