The need for a multidisciplinary approach to the diagnosis and treatment procedures of isolated lesions of the oral mucosa in herpetiform Dühring dermatitis

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Abstract

The defeat of the oral mucosa in herpetiform Dühring dermatitis is a rare pathology. According to the literature, it is detected in 9.6% — 10% of cases. Granular deposits of immunoglobulin A in the papillae of the dermis in herpetiform Dühring dermatitis are associated with gluten enteropathy, lead to the development of inflammatory processes on the skin and oral mucosa and the appearance of polymorphic itchy rashes and chronic recurrent course of the disease. The article describes a clinical case of a patient diagnosed with herpetiform dermatitis, manifestations in the oral cavity (ICD-10 — L13.0X code). The need for a multidisciplinary approach to the diagnosis, differential diagnosis, treatment and dynamic observation of isolated lesions of the oral mucosa in herpetiform Dühring dermatitis is indicated. A scheme of measures required by a dentist is developed.

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About the authors

Guzel R. Ruvinskaya

Kazan (Volga region) Federal University of the Ministry of education and science of the Russian Federation, Institute of Fundamental Medicine and Biology

Author for correspondence.
Email: guzelruv@mail.ru
Russian Federation, Kazan

E. N. Silantieva

Kazan State Medical Academy — branch of the Russian Medical Academy of Continuing Professional Education of the Ministry of health of Russia

Email: guzelruv@mail.ru
Russian Federation, Kazan

A. V. Anokhina

Kazan State Medical Academy — branch of the Russian Medical Academy of Continuing Professional Education of the Ministry of health of Russia

Email: guzelruv@mail.ru
Russian Federation, Kazan

References

  1. Yagovdik N. Z., Belugina I. N., to Boors Hadi Salah. The immediate and remote results of treatment of gerpetiformny dermatitis of Dyuringa. Ret-sept. 2007; 3(53): 83-8. (in Russian)
  2. Bonciani D., Verdelli A., Bonciolini V. et al. Dermatitis herpetiformis: from the genetics to the development of skin lesions. Clin. Dev. Immunol. 2012; 2012: 239691.
  3. Collin P., Salmi T.T., Hervonen K., Kaukinen K., Reunala T. Dermatitis herpetiformis: a cutaneous manifestation of coeliac disease. Ann. Med. 2017; 49(1): 23–31.
  4. Rashid M., Zarkadas M., Anca A., Limeback H. Oral manifestations of celiac disease: a clinical guide for dentists. J. Can. Dent. Assoc. 2011; 77: 39.
  5. Reunala T., Salmi T.T., Hervonen K., Kaukinen K., Collin P. Dermatitis Herpetiformis: A Common Extraintestinal Manifestation of Coeliac Disease. Nutrients. 2018; 10(5). doi: 10.3390/nu10050602.
  6. Patinen P. Oral Findings in Dermatitis Herpetiformis and Coeliac Di-sease. Helsinki; 2004.

Supplementary files

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1. JATS XML
2. Fig. 1. Small blisters on the hard palate.

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3. Fig. 2. Erosion of irregular shape along the transitional fold on the left and at the bottom of the oral cavity.

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4. Fig. 3. Erosion of irregular shape, covered with plaque along the transitional fold on the right and at the bottom of the oral cavity.

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5. Fig. 4. Bubbles on the hard palate that appeared 24 hours after the Jadasson test.

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6. Fig. 5. Bubbles on the mucous membrane of the floor of the mouth 24 hours after the Jadasson test.

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7. Fig. 6. 5 days after the prescribed treatment of erosion on the mucous membrane of the floor of the mouth.

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