Friday, April 14, 2017

Dermatitis Herpetiformis: Little Known Skin Disease That Is Surprisingly Common

(Excerpted from Healing without Medication)
Photo credit Louis Durhing Foundation
This disease few people have ever heard of is more common than many would expect-

Symptom Summary

∆    Chronic skin eruption of itching lesions, papules, and vesicles in clusters resembling hives

∆    Most common on the back, back of the neck, buttocks, elbows, knees, and scalp

Understanding the Disease Process

Dermatitis herpetiformis is a disease that causes intense itching with a skin inflammation resembling hives. Patients often have no sign of the original lesions by the time they go to the doctor, because the itching is so intense and the original areas of skin inflammation are covered by raw abrasions and crusts induced by scratching. Itching frequently has a burning or stinging component. The onset of burning and stinging reliably predicts the eruption of whelps on the skin 12–24 hours later.

            The underlying cause of dermatitis herpetiformis is a hypersensitivity to gliadin. This protein is a component of gluten, which is found in all forms of wheat (including durum, semolina, and spelt), rye, oats, barley and related grain hybrids such as kamut and triticale. When someone who is sensitive to gliadin consumes these grains, the intestine releases massive quantities of an immune protein called immunoglobulin A (IgA). IgA is ordinarily the body’s first line of defense against disease-causing microorganisms that enter through the skin and mucosal surfaces.

            In dermatitis herpetiformis, IgA binds to cells in the skin and treats them as if they had become infected. The body continues to secrete IgA, constantly inflaming the skin, until the affected individual stops eating foods containing gliadin or until the immune system becomes incapacitated. The benefits of changing diet, however, take several months.

            Dermatitis herpetiformis is usually diagnosed by skin biopsy but there is a less painful alternative. Your doctor can order a test for gluten sensitivity that measures gluten antibodies in saliva. For information, ask your physician to contact Great Smokies Diagnostic Laboratory in Asheville, North Carolina, 1-800-252-9303.

Treatment Summary


∆    Avoid all foods made with wheat or any other grain containing gluten. Sources of hidden gluten include caramel, gum, hydrolyzed plant protein (HPP), hydro lyzed vegetable protein (HVP), malt, maltodextrin, modified food starch, monoglycerides, diglycerides, natural flavoring, soy sauce, texturized vegetable protein (TVP), and vinegar.

Nutritional Supplements

∆    PABA (para-aminobenzoic acid):

•           Three 500-milligram extended-release tablets taken with food, 3 times daily, or

•           Aminobenzoate of potassium powder, one 2-gram packet taken with food, 3 times daily.

For no longer than 3 months:

∆    Selenium: 200 micrograms daily.

∆    Vitamin E: 1,000 IU daily.

Understanding the Healing Process

Since healing dermatitis herpetiformis with diet takes several months, many people with the condition opt to be treated with the antibiotic dapsone. This drug relieves symptoms in 24–48 hours, but anyone who takes more than 100 milligrams of the drug per day develops anemia. Other side effects may include damage to the bone marrow and liver, headache, and depression. Since the rash returns very quickly when the antibiotic is discontinued, the typical treatment strategy with dapsone and other agents for dermatitis herpetiformis is to find the lowest dosage possible while controlling symptoms, so that side effects diminish over time. As a British expert on the disease, Dr. Lionel Fry, notes, “Since side effects tend to occur early in treatment, patients may only have to attend hospital every six months once established on drug treatment.”

            Although natural healing of dermatitis herpetiformis requires discipline, it is free of side effects. Many sufferers of this form of dermatitis will choose the middle ground between medical and natural treatment, taking prescription drugs in the short term to control symptoms while waiting for diet to control the underlying disease.

            A gluten-free diet is key to healing dermatitis herpetiformis. A 25-year study of dermatitis herpetiformis in the United Kingdom found that about a third of patients experience complete remission of symptoms simply by removing wheat and other gluten products from the diet. Virtually all of the remaining two-thirds of patients achieved partial relief of symptoms by just partial adherence to the diet. People with this condition who follow a gluten-free diet are also at much lower risk for developing lipomas, tumors of fatty tissue just beneath the skin.

            Most medical authorities note that about 10 percent of people with the disease do not respond even to rigorous elimination of gluten products from the diet. Eliminating milk and eggs can help most of the dermatitis herpetiformis sufferers in this group. An enzyme-linked immunosorbent assay (ELISA) of dermatitis herpetiformis patients has found that about 75 percent have serum antibodies reactive against gliadin, cow’s milk, or the albumin protein in eggs. Completely eliminating milk and eggs followed by carefully reintroducing them in small amounts several months later is a good test of the potential efficacy of permanently eliminating them from the diet. Some milk- and egg-sensitive dermatitis patients will be able to tolerate small amounts of these foods if they strictly adhere to the gluten-free diet.

            A single study in the 1950s found that treating dermatitis herpetiformis with very large dosages of PABA (9,000–24,000 milligrams per day) controlled symptoms for as long as 30 months. Symptoms of the disease rapidly recurred when PABA supplementation was stopped. There is no evidence that taking as much as 24 grams (24,000 milligrams) of PABA daily causes any serious side effects. However, to provide a margin of safety, naturopathic physicians usually recommend taking no more than 6 grams (6,000 milligrams) of the supplement daily for no more than 3 months. Always take PABA with a full glass of water to avoid the nausea and vomiting that sometimes comes with taking high dosages of the supplement.

            There is no direct evidence that selenium and vitamin E relieve symptoms of dermatitis herpetiformis. However, both vitamins protect an antioxidant enzyme known as glutathione peroxidase, which is known to be deficient in dermatitis herpetiformis. Clinical trials confirm that supplementation with these two vitamins corrects glutathione peroxidase deficiency in 6–8 weeks, and levels continue to increase for at least 5 months, however, there is no immediate effect on symptoms of the disease.

Concepts for Coping with Dermatitis Herpetiformis

∆    If a gluten-free diet causes constipation, try drinking more water, increasing servings of fruits and vegetables.

∆    Non-food products such as lipstick, medications in pill form, and toothpaste may contain gluten. Health and beauty aids that are not ingested in normal use may be accidentally ingested when fingers come in contact with the mouth. In some cases, skin contact with a gluten is enough to cause a reaction.

∆    “Starch” in the United States is usually corn starch, which is safe for people who have dermatitis herpetiformis. “Starch” in Europe, however, is usually wheat starch, which will cause a skin reaction.

∆    Many people with dermatitis herpetiformis buy bread machines to take advantage of the many gluten-free bread mixes available on the market. If you are buying a bread machine, keep in mind that gluten-free bread mixes are very heavy and not every bread maker can process them. Brands of bread makers that process gluten-free dough include the Black & Decker All-in-One (Model B1500–04), all Wellbilt machines (sold at Sears), and the very expensive Zojirushi BBCCS-15.

∆    Be careful not to take any brand of vitamin E extracted from wheat. The formulation of vitamin E made by A. R. Grace & Company is safe for people with dermatitis herpetiformis, but the capsules themselves are made with beef gelatin and are neither halal nor kosher.

∆    Avoid fried foods, especially in fast-food restaurants. French fries are usually cooked in the same oil used to prepare breaded foods.

∆    If you drink alcohol, avoid beer (including rice beer, which contains malt), bourbon, gin, rye, and whiskey. Most vodkas do not cause a problem, and rum, sake, tequila, and wine are generally safe.

1 comment:

  1. Bagi pria, impoten atau masalah disfungsi ereksi menjadi mimpi buruk saat bercinta. Namun wanita pun sebaiknya jangan langsung meninggalkan pasangan yang mengalami kesulitan seperti itu. Jadi coba simak tips menghadapi pria impoten di atas ranjang seperti yang dilansir dari Cosmopolitan berikut ini.

    Bukan salah Anda
    Pada awalnya, wanita merasa bersalah ketika tahu bahwa pasangannya tidak terangsang. Padahal masalah disfungsi ereksi ini bukan sepenuhnya salah wanita. Sebab kondisi kesehatan pria yang sebenarnya menjadi penyebab impotensi.

    Memahami pria
    Pria yang menderita impotensi cenderung enggan bercinta dan membicarakan masalah tersebut pada pasangannya. Jadi wanita pun sebaiknya tidak menjadikannya bahan gurauan. Sebaliknya, pahami posisi pria dan jangan anggap sepele masalah ini.

    Mencari penyebab
    Ada banyak faktor yang bisa memicu disfungsi ereksi. Misalnya stres, kondisi fisik yang lemah, atau pengaruh obat-obatan. Cari tahu penyebab yang sebenarnya dari impotensi pria untuk mengatasinya dengan segera.

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