Talk:Dermatitis herpetiformis

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 4 March 2019 and 29 March 2019. Further details are available on the course page. Student editor(s): Davojann. Peer reviewers: Lms 62270.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 19:21, 16 January 2022 (UTC)

Pathophysiology
We should mention that TG3 is the autoantigen - Epidermal Transglutaminase (TGase 3) Is the Autoantigen of Dermatitis Herpetiformis. JFW | T@lk  10:38, 21 June 2006 (UTC)

And reduce the beer stuff to the necessary. JFW | T@lk  10:38, 21 June 2006 (UTC)

Redirect from Eczema Herpeticum
This is incorrect. The conditions are completely separate and distinct. Eczema herpeticum is a severe complication of eczema, when superinfection with Herpes Simplex occurs.

Images of Eczema Herpeticum

Overlap with Celiac Disease
Must both articles contain extensive discussion of communion being wheat bread?

Agreed - perhaps that topic can be spun off into its own article? Steve carlson 20:18, 10 June 2007 (UTC)

Not sure where best to post this comment, but I find that this article has a pretty major issue with mixed information. I have DH and I believe that both my doctor and my dermatologist consider DH as a symptom of Celiac Disease and this article was the first source that made me realize that is probably incorrect. I think I need to see a new doctor, heh... The article largely states that they are distinct but similar diseases BUT the introduction sequence implies otherwise. This should be fixed. Thanks. - Scott Smith 23:05, 16 September 2018 (UTC)

Thank you!
Many thanks to whoever wrote this page. I had a blistering skin condition that my doctor thought at first was an infection, then scabies, then an infection again. I was looking for info on the web and came here via dermatitis, and instantly recognised the symptoms - "Dermatitis herpetiformis is usually extremely itchy. The vesicles or papules usually appear on the elbows, knees, back, and buttocks. In most cases, it is highly symmetric. Symptoms of dermatitis herpetiformis tend to be sporadic." - yup, that's exactly what I had. A web search for images of "dermatitis herpetiformis" confirmed my suspicions. I had to wait for 9 weeks to see a dermatologist before the NHS confirmed what I already knew, and I could finally start on Dapsone. Occultations 11:28, 27 August 2006 (UTC)

Onset and consequences?
Does anyone know the average onset of symptoms after eating a gluten product? Secondly, what are the (long-term) consequences of continually eating gluten products, besides suffering with the itchy rashes? -- MacAddct1984 &#xF8FF; 00:53, 2 October 2006 (UTC)

This topic is balanced poorly
There is a huge section on beer and religious issues but practically no discussion of the mechanics of the disease.

Another article on the web states a much more complete view of the disease:

http://www.aocd.org/skin/dermatologic_diseases/dermatitis_herpeti.html

I am sorry but it looks to me (and no offense to the writer because I think the creation of these entries is a noble work) that the authour(s) didn't know a lot about how the disease works and instead wrote about the impact to their life/lives. Personally I don't care about beer or communion in the least and suspect a lot of DH sufferers would concur.

While going GF does have a huge impact on an individual's lifestyle I agree that the disease itself should be address more specifically... A link could easily be used to redirect to Celiac Disease if folks wanted to know more about GF Bread and Communion. Also one of the big DH questions that's not being address is, "If my skin care product (soap, shampoo, hairspray, etc.) has wheat/gluten in it, will it exacerbate my DH?" as well as "How long does it take for DH to clear up once I go GF?" --Fidissimus 04:33, 1 March 2007 (UTC)


 * Coeliac disease is now a featured article. The bloated topics above have been reduced to the minumum in that article. Surely a bit of work can improve the DH article as well. I disagree with Fidissimus that we should be a FAQ for DH patients. That is one thing an encyclopedia should not endeavour to be. JFW | T@lk  22:04, 26 March 2007 (UTC)

I vote against merging with Coeliac disease
If this page hadn't existed separately from Coeliac disease then I wouldn't have been able to work out what my blistering skin condition was. So please don't merge it. I don't actually know if I've got Coeliac disease, I've never had any gastrointestinal symptoms. Only about 1% of coeliacs get DH, and about 1% of people get Coeliac disease. So merging Dermatitis herpetiformis with Coeliac disease makes as much sense as merging Coeliac disease with illness. Occultations (talk) 23:46, 27 December 2007 (UTC)

DO NOT merge with celiac disease!!!
I have DH and DO NOT have celiac; I am currently a patient enrolled in a clinical research protocol at the NIH. The NIH is trying to figure out WHERE the lesions come from and WHY. It is unclear at this point whether or not DH is an auto-immune disease.....I agree that the text should reflect that there has been VERY LITTLE clinical research on this awful DH. Further, I am a staph carrier and MRSA LOVES to colonize heavily on my skin, making this condition simply awful - the lesions become infected and ulcerated. Lovely. —Preceding unsigned comment added by MHTOLLEFSON (talk • contribs) 23:44, 11 March 2008 (UTC)

I completely agree with the others - even though both articles go into a long discussion of gluten intolerance, not all people who have Coeliac disease have DH and vice versa. A better alternative might be to spin off discussions on gluten-free diets into their own article that both coeliac and DH (or other pages) could link to. I found this page doing research on a friend's condition (who does NOT have coeliac disease symptoms) I might not have found it as easily.

Do not merge with Coeliac disease, seconded
I have fought with this disease for the past year without knowing what was wrong. My primary care physician treated me for scabies (never had it), various skin conditions and finally suggested a neurosis causing me to scratch! Just last week I went to a dermatologist on referral (required for insurance coverage) and found out I have Dermatitis herpetiformis. Until researching DH I had not heard of coeliac disease -- my Drs have not mentioned it to me at all! —Preceding unsigned comment added by 64.39.1.11 (talk) 21:34, 1 March 2008 (UTC)

do not merge with coeliac disease - discussion
DH is a separate disease. its pathophysiology may work via the mechanism of coeliac disease, which is an aberrant reaction to gliaden, involving IgA immunopathy. However, patients with DH may well be sub-clinical w.r.t. CD, or not have it at all. Medical encyclopedia at medlineplus states "The cause is unknown. However, dermatitis herpetiformis is frequently linked to gluten sensitivity", written by a doctor of dermatlogy and has been peer reviewed, ie. the two diseases are separate. Furthermore, CD does not necessarily give rise to DH. Since patients can present with symptoms of either DH or CD totally separately, I think it warrants two separate wikipedia entries.

Previous discussion of this do make valid points, but some are presenting anecdotal evidence for their opinions. "I have DH and DO NOT have celiac" could describe a bullous disorder, unspecified (ICD-10 L13.9), which is clinically and histologically very similar to DH, but not actually the same.

thanks for reading forgetful (talk) 14:40, 13 June 2008 (UTC) I totally agree with this opinion, having first had DH at the age of 18 due to extreme stress (exacerbated by very slow diagnosis - had to go private in the end to get an accurate diagnosis), with subsequent very minor eruptions at subsequent times of stress, but I'm fine with gluten. J May, UK — Preceding unsigned comment added by 212.137.33.124 (talk) 10:43, 19 August 2013 (UTC)

Against merge
Pdeitiker (talk) 14:51, 14 June 2008 (UTC)
 * Patelurology2 Patelurology2 (talk) 03:07, 8 March 2010 (UTC)

Move some of this to Gluten-free diet
There are some comments above about "extensive discussion of communion being wheat bread" and "huge section on beer and religious issues". Those issues are nothing to do with Dermatitis herpetiformis as such, they are related to having to follow a gluten-free diet. They should therefore be moved/merged to Gluten-free diet. Occultations (talk) 15:25, 14 January 2008 (UTC)

I agree, is there an easier way to do it than copy and paste?? cheers, forgetful (talk) 14:41, 13 June 2008 (UTC)

Prognosis
Despite the link with gluten enteropathy, DH does not lead to small intestinal lymphoma, fracture and other typical coeliac complications: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2008.03660.x JFW | T@lk  01:35, 28 February 2008 (UTC)

Major alterations of the Page
While I am currently working through some other pages I am going to begin major alterations of this page, since few have decided to take this on. Note, I am not targeting FA or GA status with these changes, those refinements can be made after imbalances in the article are corrected, I am not a librarian or an english major, so. . . . PB666 yap 14:09, 12 July 2008 (UTC) I hope to begin this process in the next month or so, but if anyone wished to jump ahead, be my guest.PB666 yap 14:09, 12 July 2008 (UTC) Being WP:BOLD
 * 1) The religious issues section is long and redundant. A , IMHO is more than adequate, however I will look to see if there is any referenced non-redundant material in this section that can be retained.
 * 2) The Specialist breads, pastas, and beer based on my imperfect but good reading of the literature does not belong here. DH is primarily caused by immunological reaction of TGM3, epidermal transglutaminase, which means the gluten that triggers the response is in the dermis. IMHO, most of the reactivity of DH is due to skin treatment products and excessive use of soaps contaminated with gluten or wheat hydrolysates. If there is to be a discussion of products, I think the hygiene products is the place to begin. The issue of gluten-free beer can have its own page, if not already or be part of gluten-free section. The food issues can be linked by  ,
 * 3) Pathophysiology section.  I think this is a standard feature of similar pages and it seems to be warranted here.PB666 yap 14:09, 12 July 2008 (UTC)
 * 4) The Dietary impact section. This should be replaced with a Quality of life issues section similar to and a further to CD sections, but this section can also deal with special issues.PB666 yap 14:09, 12 July 2008 (UTC)

Etymology
Can someone put a quick etymology up? I'm no pro, but I'm guessing this means "inflammed skin that looks like herpes."


 * Right off the top of my head dermatitis = skin disease, herpetiformis = reptilian (or snake) form. The snake skin pattern comes from the pattern of inflammation that first appears and is later shown by red dots on the intersections.PB666 yap 16:23, 12 July 2008 (UTC)
 * Please ask questions at the end of the page, please use ~ after comments so that we know when the question was asked.PB666 yap 16:23, 12 July 2008 (UTC)

Copyright problem
This article was listed at Copyright problems/2008 July 28/Articles as a suspected copyright infringement of this source. Unfortunately, the copyright violation was substantiated. The material was introduced in 2005 by an IP editor all at one time, when the article was only a stub. All subsequent edits to the article have incorporated these substantial copyright violations. As no one had taken the opportunity provided in the seven day window to write a copyright-violation, GFDL-violation free version in article subspace as the template suggests, the copyright-infringing versions of the article have been deleted and the versions of the article prior to the introduction of the violation have been restored. I have also added in as many of the non-GFDL violating improvements as I could see that related to the existing content. If contributors to this article would like access to the existing content in order to rewrite it completely, it can be provided for that purpose. However, any version so produced can neither incorporate the existing infringement or the language of good faith contributors to the article, as the lack of attribution of these contributors is problematic. It would have to be rewritten from scratch. --Moonriddengirl (talk) 00:40, 5 August 2008 (UTC)
 * Wow that sucks. It was very useful to people like me with this condition when it was up too. (MGoers37 (talk) 00:14, 18 September 2008 (UTC))

I have rewritten this page from scratch to fix the copyright problem.Occultations (talk) 12:45, 12 August 2009 (UTC)

Various small changes
I have fixed some inaccuracies that have crept in. And I've changed some things back for the following reasons: Occultations (talk) 12:44, 12 August 2009 (UTC)
 * "The blisters vary in size from very small up to 1 cm across." - moved this back to the paragraph that first mentions the blisters, rather than one that talks about the itching or burning sensations that might or might not occur.
 * Changed the link from Linear IgA bullous dermatosis back to Adult linear IgA disease, because everything on the Linear IgA bullous dermatosis page is not relevant, apart from the link to Adult linear IgA disease.
 * Changed the capitalisation of "Dapsone" back to "dapsone", except at the start of a sentence. This seems to be standard practice with drug names (see, for example, the Dapsone page).
 * Changed "Dapsone treatment has no effect on gluten sensitivity" to "dapsone treatment has no effect on intestinal damage", because the point is that a gluten-free diet does correct the intestinal damage. I have avoided enteropathy because that link wasn't helpful.  The link I've given is to coeliac disease, because the picture there of the villi is exactly what's needed to illustrate the damage.

Please leave linked to Celiac
This article as is..> dermatitis herpetiformis .... the rash which looks like excema because it weeps inflames a couple hours to the worst of it 10 -12 hrs after eating gluten or wheat. This rash can be on the folds of the skin anywhere .. on the back of the neck around mouth in folds of skin on face, ( corner nose.. inbetween brows around hairline in folds of smile lines and under the chin)This rash also occures under arms in between legs inbetween folds of buttocks and causes severe itching in all those areas. It is very hard to find any information on this subject that fits all of the symptoms however all of this together makes sense if you have the connection to this link from celiac because it gives a name to the symptoms. If you look up celiac it mentions nothing of a rash. Having the link between dermatitis herpetiformis and celiac also explains how one... if they have the rash may go about treating it by avoiding wheat and gluten if doctor prescribed medications fail to fix the problem. — Preceding unsigned comment added by 99.100.188.58 (talk) 21:50, 19 December 2011 (UTC)

UCSF WikiMedicine Project - Spring 2019
Hello everyone, I am a fourth year medical student at UCSF who is enrolled in an elective designed to review and update selected Wikipedia articles and I have decided to tackle this article. While I think this article is quite well written, I notice there haven't been many significant changes in the past few years. There are a few things that I would like to review and update/clarify listed below that I think may strengthen this article even more. Please let me know what you all think of this plan and if you have any comments / suggestions for improvement.

The Lead:
 * I think it would be helpful to state in the first paragraph that the lesions are very itchy.
 * The current paragraph states that men and women are affected equally, while uptodate and celiac.org state that there is a slight M>F predominance in DH.
 * I would like to change the first image on this article to better reflect the typical distribution of this rash.

Signs and symptoms:
 * I would like to change this sentence somewhat to better reflect that individuals who first present with DH and have concomitant Celiac disease typically do not display the characteristic signs and symptoms of celiac's disease: "Sometimes, these symptoms may be accompanied by symptoms of coeliac disease, commonly including abdominal pain, bloating or loose stool, and fatigue."

Pathophysiology:
 * I will review this content for accuracy and see if there are any new updates in the field regarding the specific mechanisms of disease.

Diagnosis:
 * I would also like to include here that the concomitant diagnosis of celiac disease can be made after biopsy-proven DH and supporting serologic studies - no need for a small bowel biopsy is indicated (See section "Dermatitis Herpetiformis" - https://www.uptodate.com/contents/diagnosis-of-celiac-disease-in-adults?topicRef=15307&source=see_link#H3808958813).

Treatment:
 * Currently, alternative treatments to dapsone are simply listed - I would like to expand on the available treatment options and also include options with fewer adverse side effects that are over-the-counter, such as niacin.
 * I would also like to discuss the role that topical steroids can have in ameliorating the itch associated with the rash.

Prognosis:
 * I will review this section for accuracy and see if there are any new updates in the literature.
 * I will also review the consensus on if the incidence of "intestinal lymphomas" are increased in patients with DH / Celiac's disease, as this has been debated.

Timeline:

March 4: Start of elective

March 8: Proposed work-plan and timeline of changes.

March 11: Update the 'lead' and 'signs and symptoms' sections to include the proposed changes. Will also review the 'pathophysiology' section for accuracy.

March 15: Match day - take the next couple days off

March 20: Update the 'diagnosis' and 'treatment' sections with the proposed changes.

March 23: Review 'prognosis' section

March 25: Peer-review work

March 26-27: Final edits / updates.

March 28: End of course — Preceding unsigned comment added by Davojann (talk • contribs) 03:14, 9 March 2019 (UTC)

I'm excited to be contributing to this amazing Wikipedia article and hopefully providing individuals around the world with helpful, easy to understand information that is accurate and up to date. Please let me know what you all think of my proposed changes/updates and any comments for improvement! Thank you! — Preceding unsigned comment added by Davojann (talk • contribs) 03:07, 9 March 2019 (UTC)

Peer Review for Wikipedia course Spring 2019
You did a great job adjusting the article for accuracy and reorganizing the various sections for simplicity and flow. You also added great information about ongoing studies about treatment/prevention with a new vaccine and various treatment options.

You have made great progress to reach your goals based on the timeline on your talk page. Some things to think about moving forward include: - For treatment, think about organizing the section based on what is the recommended first line, second line, etc (and make it clear that's what you are doing). It makes for a more fluid read and helps patients clearly understand the typical recommended order of treatments. - Expand the differential diagnosis section in 'Diagnosis'. - Include a history section if there is any relevant information available.

Great work!! — Preceding unsigned comment added by Lms 62270 (talk • contribs) 00:15, 25 March 2019 (UTC)