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Dermatitis herpetiformis Duhring

Etiology and pathogeneses not is known, usually developing by people with syndrome malabsortion and formation then immunoallergic reaction. Observed number patient show in the biopsies is atrophic piles of intestine. Usually more signs enteropaty are because increase sensitive for gluten, including of protein herb. Used of therapy anti gluten diet bring for improvement of clinically symptoms and normalized function mucous membrane of intestine. Because there is genetic likeness this pathology has bounding with HLA complex.

In the blood of ill has scow circulation antibody from gluten.

Because damage mucous membrane of intestine subs tans with antigens signs penetrate through damageable mucous membrane.

Showing composes IgA in the skin discovering by 80% of patients.

Increase IgA in serum of blood and bullís solution there is different-diagnoses sign.

Clinically picture. A disease usually begging is subjective sensation of itching, burning and tension. Eruption by herpetiformis dermatitisís Duhring characterized true polymorphism. Firstly elements may separation 1) blister erythematous elements, they grouping, formation different figures; 2) tensionless vesicles on the edema erythematous bases, they have tendencies from grouping and herpetiformis arrevgement. They are opening and formation erosion on the edemaís bases, on the peripheral van can see scrappy of vesicles; then formation crusts, under they rapidly epitheliumness; 3) bulls form appear usually by elderly people and characterized developing tensionless bulls on the back-ground other elements;

Surround of erosions are on the hyper pigmentation fireplaces may appear now free herpetiformis elements. Into contents of bulls discover eosinophils (10-30) as well eosinophils discover in blood.

Symptom Nicolscogo is negative and into smear-print acantolitic cells not look.

Usually herpetiformis dermatitisís Duhring look as paraneoplasia.

Provocation factors are emotional stress, used drugs, by tames pregnancy and action ultraviolet light.

Treatment. Patient must be examining diseases of digestive, and except malignant internal organs.

This tames used drugs sulfone group: diaphenilsulfon (DDS, Dapson, Avlosulfon, Diuzifon). Optimum doses sulfone drugs 50-100 mg a day long 5 a day and 1 day interruption; maximally doses is 200 mg a day.

If sulfone drugs none effective used glucocorticoid is middle doses.

Diuzifon is drug including 2 component DDS and 6-methilurasil, prescribe 0,1-0,2 g a day long 5 day and 1 day interruption.

Good action Unitiol; antioxidants Ė Lipoid acid, Methionin, Etamid.

In the adding therapy used vitamins B group, ascorbinity acid, rutin, antihistamine drugs.

In the difficult case used Colchicinum 0,6 mg 3 a day dragger (this drug used treatment of podagre)

External therapy including are crèmes, aerosols with glucocorticoid, antibiotics and paint.

 


Date: 2014-12-21; view: 1189


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