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Dermatitis herpetiformis (DH), or Duhring's disease,〔Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.〕 is a chronic blistering skin condition, characterised by blisters filled with a watery fluid.〔 Despite its name, DH is neither related to nor caused by herpes virus: the name means that it is a skin inflammation having an appearance similar to herpes. DH was first described by Louis Adolphus Duhring in 1884.〔 A connection between DH and coeliac disease was recognised in 1967, although the exact causal mechanism is not known. DH is a specific manifestation of coeliac disease.〔(【引用サイトリンク】title= Dermatitis Herpetiformis )〕 The age of onset is usually about 15-40, but DH can also affect children and the elderly. Men and women are equally affected. Estimates of DH prevalence vary from 1 in 400 to 1 in 10000. It is most common in patients of northern European/northern Indian ancestry, and is associated with the HLA-DQ2 haplotype along with coeliac disease and gluten sensitivity.〔〔(【引用サイトリンク】publisher=Patient UK )〕〔(【引用サイトリンク】publisher=National Digestive Diseases Information Clearinghouse )〕 == Signs and symptoms == Dermatitis herpetiformis is characterized by intensely itchy, chronic papulovesicular eruptions, usually distributed symmetrically on extensor surfaces (buttocks, back of neck, scalp, elbows, knees, back, hairline, groin, or face).〔〔 The blisters vary in size from very small up to 1 cm across. The condition is extremely itchy, and the desire to scratch can be overwhelming.〔 This sometimes causes the sufferer to scratch the blisters off before they are examined by a physician.〔 Intense itching or burning sensations are sometimes felt before the blisters appear in a particular area.〔〔 Untreated, the severity of DH can vary significantly over time, in response to the amount of gluten ingested. Dermatitis herpetiformis symptoms typically first appear in the early years of adulthood between 20 and 30 years of age.〔(【引用サイトリンク】 title=Dermatitis Herpetiformis )〕 Although the first signs and symptoms of dermatitis herpetiformis are intense itching and burning, the first visible signs are the small papules or vesicles that usually look like red bumps or blisters. The rash rarely occurs on other mucous membranes, excepting the mouth or lips. The symptoms range in severity from mild to serious, but they are likely to disappear if gluten ingestion is avoided and appropriate treatment is administered. Dermatitis herpetiformis symptoms are chronic, and they tend to come and go, mostly in short periods of time. Sometimes, these symptoms may be accompanied by symptoms of coeliac disease, commonly including abdominal pain, bloating or loose stool, and fatigue. The rash caused by dermatitis herpetiformis forms and disappears in three stages. In the first stage, the patient may notice a slight discoloration of the skin at the site where the lesions appear. In the next stage, the skin lesions transform into obvious vesicles and papules that are likely to occur in groups. Healing of the lesions is the last stage of the development of the symptoms, usually characterized by a change in the skin color. This can result in areas of the skin turning darker or lighter than the color of the skin on the rest of the body. Because of the intense itching, patients usually scratch, which can lead to the formation of crusts. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Dermatitis herpetiformis」の詳細全文を読む スポンサード リンク
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