Diagnosis dan Tata Laksana Dermatitis Herpetiformis
DOI:
https://doi.org/10.55175/cdk.v49i5.232Kata Kunci:
Dapson, dermatitis herpetiformis, glutenAbstrak
Dermatitis herpetiformis (DH) merupakan penyakit kulit autoimun kronik-residif akibat proses sekunder hipersensitivitas terhadap gluten. Kejadian DH tinggi pada populasi dengan predisposisi genetik HLA-DQ2 atau DQ8. Manifestasi klinis DH berupa lesi polimorfik ruam papulo-vesikular atau papul-eskoriasi didominasi rasa gatal. Baku emas diagnosis DH adalah pada pemeriksaan DIF didapatkan deposit imunoglobulin (Ig)-A granular di stratum papila dermis. Diet bebas gluten merupakan tata laksana utama. Dapson menjadi obat pilihan pertama. Prognosis baik dengan diagnosis dan tata laksana yang tepat.
Dermatitis herpetiformis (DH) is a chronic-recurrent autoimmune skin disease caused by secondary hypersensitivity to gluten. The incidence of DH is high in population with genetic predisposition to HLA-DQ2 or DQ8. Clinical manifestations of DH are polymorphic lesions, papulo-vesicular rash or papules-excoriations, dominated by itching. The gold standard for diagnosis is the presence of granular immunoglobulin (Ig)-A deposits in the stratum papilla dermis on DIF examination. A gluten-free diet is the mainstay of treatment. Dapsone is the drug of choice. Prognosis is good with proper diagnosis and treatment.
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Clarindo M, Soligo E, Ruaro R, Possebon A, Uyeda H, Empinotti J. Dermatitis herpetiformis: Pathophysiology, clinical presentation, diagnosis, and treatment. Bras Dermatol. 2014;89(6):865–77.
Antiga E, Caproni M. The diagnosis and treatment of dermatitis herpetiformis. Clin Cosmet Investig Dermatol. 2015;8:257–65.
Ohata C. Dermatitis herpetiformis: A cutaneous gluten-related disorder with possible exception in Asians patients. J Dermatol Res Ther. 2016;2(6):1–3.
Nguyen C, Kim S. Dermatitis herpetiformis: An update on diagnosis, disease monitoring, and management. Medicina (Mex). 2021;57(843):1–15.
Bonciolini V, Bonciani D, Verdelli A, D’Errico A, Antiga E, Fabbri P, et al. Newly described clinical and immunopathological feature of dermatitis herpetiformis. Clin Dev Immunol. 2012;2012:967974. doi: 10.1155/2012/967974
Handa S, Dabas G, De D, Mahajan R, Chatterjee D, Saika U, et al. A retrospective study of dermatitis herpetiformis from an immunobullous disease clinic in north India. Int J Dermatol. 2018;57(8):1–6.
Hull C, Zone J. Dermatitis herpetiformis and linear IgA bullous dermatosis. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. United States: Elsevier Saunders; 2018. p. 527–33.
Anwar M, Rashid A, Tahir M, Ijaz A. Guidelines for the management of dermatitis herpetiformis. J Pak Assoc Dermatol. 2013;23(4):428–35.
Vale E, Dimatos O, Porro A, Santi C. Consensus on the treatment of autoimmune bullous dermatoses: Dermatitis herpetiformis and linear IgA bullous dermatosis – Brazilian society of dermatology. Bras Dermatol. 2019;94(2):48–55.
Katz S. Dermatitis herpetiformis. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s dermatology in general medicine. 9th ed. United States: McGraw-Hill; 2019. p. 1002–7.
Cinats A, Parsons L, Haber R. Facial involvement in dermatitis herpetiformis: A case report and review of the literature. J Cutan Med Surg. 2019;23(1):35–7.
Anokhina A, Silantyeva E, Ruvinskaya G. Clinical case of isolated lesion of oral mucosa by dermatitis herpetiformis. BioNanoscience 2020;10:311–4.
Simpson M, Cowen E, Cho S. Acral petechial eruptions without gastrointestinal symptoms: Three cases of dermatitis herpetiformis. JAAD Case Rep. 2020;6:935–8.
Weiss A, Nawrocki S, Laureano A, Scherl S, Shulman K, Kwon E. A rare case of dermatitis herpetiformis presenting as fingertip petechiae. SKIN J Cutan Med. 2020;4(1):68–71.
Kern M, Kim K, Johnson G, Hawkins S, Wong H. Dermatitis herpetiformis presenting as pseudovasculitis. JAAD Case Rep. 2017;3:444–7.
Ohata C, Ishii N, Hamada T, Shimomura Y, Niizeki H, Dainichi T, et al. Distinct characteristics in Japanese dermatitis herpetiformis: A review of all 91 Japanese patients over the last 35 years. Clin Dev Immunol. 2012;2012:562168. doi: 10.1155/2012/562168.
Antiga E, Verdelli A, Calabro A, Fabbri P, Caproni M. Clinical and immunopathological features of 159 patients with dermatitis herpetiformis: An Italian experience. G Ital Dermatol Venereol. 2013;148(2):163–9.
Lee R, Lobo Y, Spelman L. Development of dermatitis herpetiformis in chronic plaque psoriasis. Case Rep Dermatol. 2021;13:141–7.
Goh C, Pan J. Dapsone. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s dermatology in general medicine. 9th ed. United States: McGraw-Hill; 2019. p. 3423–9.
Ralph J, Kelly A, Lally A, Kirby B. Recalcitrant dermatitis herpetiformis treated successfully with sulfasalazine. Int J Dermatol. 2020;60(4):1–2.
Wang Y, Yang B, Zhou G, Zhang F. Two cases of dermatitis herpetiformis successfully treated with tetracycline and niacinamide. Acta Dermatovenerol Croat. 2018;26(3):273–5.
Nguyen K, Gwinn C, Vary J. Rituximab treatment for dermatitis herpetiformis in the setting of type 1 diabetes mellitus, celiac disease, vitiligo, autoimmune hemolytic anemia, and autoimmune thrombocytopenia. JAAD Case Rep. 2020;6:122–3.
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