Suggest alternative treatment for dermatitis herpetiformis

Posted on Wed, 18 Nov 2015 in Skin Hair and Nails
Question: My daughter is 15yrs old. She has been diagnosed with Dermatitis herpitiformus (DH) during 2013. Since then she is on dapsone 10mg one tablet at night. Due to prolonged use of steroids she is experiencing hairfall and little weight gain. Is there no cure for DH? How can I help my daughter to be normal again ? Skin blisters are still coming if we stop dapsone even for a day or two. Glutenfree food only she is able to have. Any advice from dermatology experts will be highly appreciated. Thanks in advance.
Answered by Dr. VINAY KUMAR 10 hours later
Brief Answer:
This information will help your daughter!

Detailed Answer:

Welcome to this site!

I am Dr V XXXXXXX a dermatologist.
I have noted and assessed your concerns.

Dapsone is one of the best drugs for treatment for DH.The good part is that it is well tolerated and is fairly safe. Please note that it is not a steroid and therefore, is not linked to weight gain and hair fall.

Treatment for DH is a long journey but most patients do well with the current treatment. In the case of your daughter, i would suggest not to consider alternatives as their toxicity is more bothersome than the disease itself.
You are suggested to get your daughter's tests done regularly especially from the point of view of Hemolytic anemia, blood counts, neurological assessment, and urine examinations.

She should be not be given anti inflammatory agents but Brufen is quite safe.
Some patients have been helped by Ultraviolet light therapy.

You are also advised not to stop Dapsone abruptly although tapering under supervision is one possibility worth consideration.

Please keep your focus on Gluten freed diet.

I hope this information helps as this is time tested in large number of patients.

Our best wishes, always!

Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. VINAY KUMAR 10 hours later
Thank You Dr. XXXXXXX XXXXXXX I really appreciate your guidance & opinion. As you can understand well, XXXXXXX is a 15yr old girl child & as her parents we feel sorry for seeing her troubles. (example: Even regular snacks/bakery items/cookies/cakes have wheat in it and she can not consume like other children of her age). Also, some sort of inferiority complex she has developed due to the blisters which are questioned by people who are not aware of her situation. Hence, it makes it all the more difficult to deal.

We will follow your advise. Will get routine blood/urine tests also done to monitor and avoid anemia risk.

Thanks again.

XXXX & Family
Answered by Dr. VINAY KUMAR 3 hours later
Brief Answer:
Your concerns are logical and correct

Detailed Answer:

I appreciate your words and empathize with you cos any concerned parent or family member would have felt exactly like that.

In your concerns, you are not alone.

As XXXXXXX is going through a very tender phase of life, it is perfectly in order for her to feel what you stated.Only patience, perseverance, and loving counseling can fill the gaps.

Please focus on her positive traits and remind her that her inconvenience is nothing as compared to grave situations many others have to go through.

I am sure she will lead an absolutely normal life and your anxiety will settle. I am always ready to help in whatever way you need it.

Our best wishes!

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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