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Choroba Duhringa – przyczyny, objawy, leczenie

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Choroba Duhringa, czyli opryszczkowate zapalenie skóry, to przewlekłe schorzenie o podłożu autoimmunologicznym. W przebiegu choroby występują objawy skórne oraz jelitowe. Jak rozpoznać i leczyć chorobę Duhringa?

Przyczyny choroby Duhringa

Patogeneza choroby nie została w pełni poznana. Zakłada się, że rolę odgrywają w niej zarówno czynniki środowiskowe, jak i genetyczne.

We krwi osób chorujących na opryszczkowate zapalenie skóry występują przeciwciała skierowane przeciwko macierzy komórkowej endomysium mięśni gładkich, które mogą być indukowane przez gluten. Z tego powodu chorobę Duhringa określa się również skórną postacią celiakii. Schorzenie to częściej występuje u osób, w rodzinie których występowała wcześniej celiakia. Choroba Duhringa może współistnieć z innymi schorzeniami o podłożu autoimmunologicznym, takimi jak bielactwo, cukrzyca typu 1 czy autoimmunologiczne zapalenie tarczycy. Do rozwoju zmian skórnych może doprowadzić również ekspozycja na chlorowce, szczególnie jod.

Choroba ma charakter przewlekły, nawrotowy, z okresami zaostrzeń i remisji.

Objawy choroby Duhringa

Wykwity skórne w przebiegu choroby Duhringa przyjmują postać zmian wielopostaciowych – pęcherzy, grudek z drobnymi nadżerkami, krost, zmian rumieniowych oraz pokrzywkowatych. Zmiany mają różowe bądź białe zabarwienie, często są wypełnione płynem. Przyjmują festonowaty lub opryszczkowaty układ i układają się symetrycznie. Możliwe jest również występowanie przeczosów oraz przebarwień pozapalnych.

Wykwitom towarzyszą świąd, pieczenie oraz dolegliwości bólowe, których nasilenie nie odpowiada zmianom chorobowym. W następstwie drapania przez pacjenta zmienionych chorobowo obszarów dochodzi do powstawania wtórnych zadrapań i ran, a następnie strupów i blizn. W obrębie swędzących zmian skórnych może dojść do wtórnego zakażenia.

Zmiany najczęściej występują w obrębie kolan i łokci, w okolicy krzyżowej i na pośladkach, a także w okolicy łopatek. Mogą się również pojawić na twarzy i owłosionej skórze głowy. W części przypadków zmiany obejmują czerwień wargową oraz błony śluzowe jamy ustnej.

Leczenie choroby Duhringa

W terapii choroby Duhringa stosuje się sulfony, które niwelują uczucie świądu oraz ograniczają zmiany skórne. Ważnym elementem profilaktyki jest stosowanie diety bezglutenowej.


Przeczytaj także: Naukowcy opracowali biomateriał, który stymuluje gojenie ran

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