Atlas De Dermatologia Fitzpatrick Pdf
Dermatitis herpetiformis (DH) or Duhring-Brocq disease is a chronic bullous disease characterized by intense itching and burning sensation in the erythematous papules and urticarial plaques, grouped vesicles with centrifuge growth, and tense blisters. There is an association with the genotypes HLA DR3, HLA DQw2, found in 80-90% of cases. It is an IgA-mediated cutaneous disease, with immunoglobulin A deposits appearing in a granular pattern at the top of the dermal papilla in the sublamina densa area of the basement membrane, which is present both in affected skin and healthy skin. The same protein IgA1 with J chain is found in the small intestinal mucosa in patients with adult celiac disease, suggesting a strong association with DH. Specific antibodies such as antiendomysium, antireticulina, antigliadin and, recently identified, the epidermal and tissue transglutaminase subtypes, as well as increased zonulin production, are common to both conditions, along with gluten-sensitive enteropathy and DH. Autoimmune diseases present higher levels of prevalence, such as thyroid (5-11%), pernicious anemia (1-3%), type 1 diabetes (1-2%) and collagen tissue disease.
The chosen treatment is dapsone and a gluten-free diet. INTRODUCTION Bullous diseases constitute one of the most extraordinary chapters of dermatology.
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Pathophysio logical mechanisms diversity subordinated to its varied etiology, extensive range of clinical manifestations with often systemic disease involvement, require a well-conducted medical evaluation method; therefore, translate into surprising difficulties that require specialized treatment and habilitation in overcoming the diagnostic and therapeutic challenge. The bubbles are efflorescence filling with liquid composed of plasma and inflammatory cells, resulting from the change of cell structures and intercellular junctions structures responsible for the adhesion of epithelial tissue. - Vesicles are known as the diameter of the cavity less than 0.5 cm, and bubble is greater than 0.5 cm, intraepidermal if the lesion is present in the basal layer to the stratum corneum. - Through knowledge of the pathophysiology of the cleavage plane, the characteristics of the inflammatory infiltrate and especially the mechanism of blistering, it is possible to distinguish bullous dermatoses.
DERMATITIS HERPETIFORMIS Dermatitis herpetiformis (DH) was described in 1884 by dermatologist Louis Duhring, who placed it in the same clinical category as pemphigus and pemphigoid, thus composing the class of bullous diseases.,, In 1888 Brocq described similar skin lesions diagnosed as 'polymorphic pruritic dermatitis' and after examining Duhring's report, admitted that it was the same pathology. Therefore, Duhring-Brocq's disease is now used as a synonym for DH. In 1943, through distinction of vesiculation mechanism, Civatte differentiated pemphigus (intraepidermal bullae), pemphigoid and DH (blistering of the basement membrane zone). The association with celiac disease, a glutensensitive enteropathy, and DH was observed in the sixties by Mards et al. Download Encore 5 Full. , Fry et al. Cara Keygen Corel X5 Serial Number. Direct immunofluorescence.
Fluorescence in granular pattern in the basement membrane zone Indirect immunofluorescence may be useful to detect the presence of autoantibodies and circulating anti-endomysial, anti-gliadin, and anti-reticulin IgA, and anti-epidermal transglutaminase antibodies., Tissue transglutaminase antibodies (anti-tTG) can be measured by ELISA, showing greater than 90% specificity and sensitivity of 47-95%. It is used to diagnose DH and to assess patients adhesion to glutenfree diets and intestinal damage. Anti-tTG is 64% homologous to anti-epidermal transglutaminase (anti-eTG), which acts against the specific antigen in DH., Jaskowski et al. Suggest that 20% of patients have anti-tTG negative, but these patients are antieTG positive. The same authors found a higher sensitivity of anti-eTG, which may help in cases of difficult diagnosis.