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Doctors' Answers to "Frequently Asked Questions" - Dermatatitis Herpetiformis

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Causal Factors
Question:I have a DX of dermatitis herpetiformis. I am on 100mg. of dapsone a day. What other conditions may cause the der. herpetiformis other than celiac disease. I have not been put on a gluten restrictions. How long long can one stay on the dapsone?

Answer: Dermatatitis herpetiformis is a skin condition characterized by itchy, raised areas over the extensor parts of the body(elbows, knees etc.). Almost all patients have a guten sensitivity and most have genes that are common in this disease. Diagnosis should be performed by biopsy since this is tough to diagnose just by observation. In some patients, a gluten free diet will clear the skin lesions. Almost all patients will have an abnormal small bowel biopsy even in the absense of clear symptoms. There is an increased tendency to have thyroid problems, and some specialized stomach problems. Treatment of these does not alleviate the skin condition. Dapsone is the usual treatment. However, this drug needs close follow-up due to its ability to cause problems. Dapsone can cause hemolysis(breakage of blood cells) and does shorten the life span of red blood cells. Neuropathy is occasionally seen with muscle weakness. Nausea, vomiting and pancreatitis are also seen. In general, this drug is used for as short a period as possible.
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