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Dermatitis Herpetiformis: Treatment, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the Dermatitis Herpetiformis?

Dermatitis Herpetiformis or DH is a chronic rash like condition of the skin, where itching, redness and blisters are a common symptom. It can be excruciatingly difficult to live with the condition, as the chronic itching occurs around the elbows, knees, back, scalp and buttocks. The condition often occurs due to a gluten intolerance.

The inability to digest or process gluten derived from food is commonly known as celiac disease. Therefore, DH is a condition that results from celiac disease. Celiac disease is an autoimmune disorder, for which there is no cure. The only option is to stay away from food that contains gluten. However, DH can be cured, even though it may take a bit of time. Almost 15 to 25 percent of people with celiac disease also suffer from DH.

While medication can be used to cure the symptoms of DH, the side effects of such medicines can be quite severe. This is why a lot of thought and consideration needs to be put in before picking a course of treatment. However, the best way to avoid the symptoms of DH is to completely avoid food with gluten.

How is the Dermatitis Herpetiformis treatment done?

People with dermatitis herpetiformis will suffer from rash, redness, blisters and excessive itching. The itching can be the most difficult symptom to manage and live with. Generally, a skin biopsy is performed to diagnose the condition. A small skin sample from the area of infection will be extracted. A blood test can also be used to detect the antibodies related to DH.

The primary drug used to treat DH is called Dapsone. However, Dapsone can have a number of serious side effects, which includes sensitivity to sunlight, liver issues, anemia, peripheral neuropathy and muscle weakness. Dapsone also interferes with other medication such as aminobenzoate potassium and clofazimine.

Alternatives to Dapsone include tetracycline, sulphapyridine, and other immunosuppressive drugs. However, these alternative drugs are not as effective on DH as Dapsone.

The safest form of treatment for DH is to stay away from gluten products, such as barley, oats, wheat, rye. Such a diet may be difficult to follow, but the benefits of the same far outweighs the problems.

Who is eligible for the treatment? (When is the treatment done?)

People who have been diagnosed with dermatitis herpetiformis can seek treatment for the same. If treatment with Dapsone results in several side effects, doctors may prescribe different medications to the patient as well.

Who is not eligible for the treatment?

Dapsone treatment may not be suitable for every patient. People suffering from liver conditions or anemia may not be allowed to take Dapsone, as it may alleviate the issues from the same. Even when Dapsone is used, doctors slowly increase the dosage over a period of months, so as not to cause too many side effects.

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Are there any side effects?

Dapsone is the primary medication in case of DH. Treatment with this drug shows the greatest results, but it can also cause severe side effects. For instance, treatment with it can cause liver conditions, anaemia, peripheral neuropathy, muscle weakness and sensitivity to light. Dapsone is considered to a very powerful drug, which is why physicians will introduce the dosage slowly.

What are the post-treatment guidelines?

Since DH cannot be cured completely, the treatment and lifestyle changes needs to be followed throughout life. For instance, medication and a diet without gluten can be very helpful in managing the condition.

How long does it take to recover?

Since there are no permanent cure for the disease, there cannot be a time for the recovery. With proper diet and medication, the condition can be managed and a person can lead a relatively normal life. Usually, Dapsone treatment results in almost immediate relief from the chronic symptoms of the disease and the rest of the issues can be handled with proper gluten free diet.

What is the price of the treatment in India?

Price of treatment in India is around Rs. 5,000 to Rs. 10,000. The pricing varies from one place to the next.

Are the results of the treatment permanent?

Results of the treatment are not permanent. the DH may relapse fro a while, but will eventually return if patients stop taking medications and start having food containing gluten. So, patient's should try to follow the diet plans that doctors create for them.

What are the alternatives to the treatment?

Alternative treatments include ayurvedic remedies, such as neem capsules, Gandhak Rasayan, Carcumin Capsules and Digestion Support Capsules. Although such treatments may result in small benefits for some patients, chronic DH patients should rely on the traditional forms of medication and treatment, in order to receive the benefits.

References

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Written ByDr. Shaurya Rohatgi MD - Dermatology , Venereology & Leprosy,MBBSDermatology
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