Duhring-Brocq's Herpes Dermatitis: How Is It Diagnosed and Treated?

Duhring - Brocq (DH) is an autoimmune, inflammatory skin disease called Herpes. This is a disease that causes skin lesions to be lumpy, vesicular, causing severe itching, characterized by lesions distributed symmetrically on extensor surfaces on the body such as elbows, knees, buttocks, scalp, nape, etc. thighs, then back and abdomen..., rarely in the axillary interstitium, sacral region. The majority of lesions are symmetrical in nature.
Duhring-Brocq's Herpes Dermatitis is seen mainly in Caucasians and is common in the age group of 20-40 years.

The patient may have a slight fever or not, body fatigue, insignificant weight loss. Feeling itchy, followed by a burning sensation or pain in the itchy skin.

Initially, the onset of the lesion is the appearance of a red rash, vesicles, urticarial papules, then gradually appear as vesicles. Blisters often appear on red, irritated skin. The size of the pimples is about the size of a corn grain, tight, round and glossy. The inside of the acne contains a lemon-yellow fluid, rarely the blisters hemorrhagic, around the blisters there are red halos. The blisters last for 5-7 days, then the blisters become cloudy (if there is superinfection). After a few days, the vesicle bursts, leaving a slick, crusted, pus-filled scab.

The location of skin inflammation is often on elbows, knees, back, buttocks, mucosal lesions are uncommon (only about 4.6%). In many patients, the disease develops or worsens within hours or days of eating a gluten- or iodine-containing diet. In addition, dermatitis herpetiformis can also be seen in people with type 1 diabetes, thyroid disease, blood malignancies and lymphomas.

4.1 Diagnosis of disease To diagnose disease requires blood test; or immunofluorescence test for diagnosis.
4.2 Treatment of dermatitis herpetiformis The treatment of dermatitis herpetiformis topical mainly uses antiseptic solutions such as: Milian, methyl purple, methylene blue applied to the lesions. In case the lesions still have blisters and blisters, they should be removed by using a sterile needle to poke them out and absorb the fluid before applying the medicine. For dry skin lesions can apply chloroxide ointment, flucinar. In case of severe dermatitis, the patient may be prescribed systemic drugs as follows: Use corticosteroids 30-40mg/day, then gradually reduce the dose for 4-8 weeks. Use the antibiotic erythromycin orally 1 - 1.5g / day for each 7 days for 2 - 3 times. Patients respond quickly (within 1-2 days) to dapsone, but close monitoring is required to avoid complications.

In addition, the patient needs to supplement nutrition, take care of the area, keep body hygiene, clean and disinfect, dry the skin inflammation, improve the general condition of the patient by exercising to improve health. strong. Diet also needs attention, patients need to limit eating foods with a lot of gluten such as rice, corn. It is necessary to carry out the treatment according to the doctor's instructions and re-examine on time. When having symptoms of dermatitis herpetiformis as above, it is necessary to quickly go to the nearest hospital, medical center, dermatology clinic for early examination and timely treatment.
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