Aug
20
Pneumonia is a very serious condition that also has some very severe complications. Pneumonia is on the third place on the list of most frequent causes of hospitalization. More than a million and a half people that suffer from pneumonia are hospitalized every year. Although most of the people that suffer from pneumonia respond very well to treatment and most of them are cured, the infection caused by pneumonia is still a serious problem that can bring a lot of complications. In some countries, pneumonia is the first cause of death because of an infection.
The severity of pneumonia depends on several factors like age, the state of their health or weak immune system. However, even if you do not suffer from a very serious case of pneumonia, there is always the risk of developing a complication. The most common pneumonia complications are: abscesses, respiratory failure and bacteremia.
Abscesses are some of the most dangerous pneumonia complications. These are cavities filled with pus that are found in your lungs. Besides the fact that they are filled with pus, these pneumonia complications also have thick walls and they form when the infection that you have has destroyed your lung tissue. These pneumonia complications are t
he result of a mixture of organisms that are carried into your lungs. If these abscesses are not treated, this can cause hemorrhage and thus can lead to death. However, there are many antibiotics available that can reduce the risk of death or hemorrhage considerably.
Another complication of pneumonia can be respiratory failure. This is actually the main cause of death in patients that suffer from pneumococcal pneumonia. When your lungs are not able to function properly, the quantity of oxygen is reduced and you risk to die. As you can see, this is a very serious pneumonia complication. Failure to breath can happen from the changes in your lungs that occur when you suffer from pneumonia. Failure can also occur when you loose the needed oxygen from your arteries when your pneumonia case results in a very abnormal flow of the blood.
The third pneumonia complication is bacteremia, that means bacteria in your blood. This is one of the complications that mostly happens in cases of streptococcus pneumonia. However, there are few the cases where this infection actually spreads to other locations of your body. Bacteremia is also a very common complication of some other gram negative microbes, which include haemophilus influenzae.
Aug
20
Is your dog too stuck on you
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Being alone can be really frightening, especially when you are a kid. A natural reaction of a child when left alone is to
cry. We have all gone through this when we were young, We were always glued to our parents, especially to our moms. We do not
want to be away from them. This is human instinct since when we were born, our mom is the first person that we lay our eyes
on. in fact, we’ve already formed an attachment when we were still inside our mother’s womb.
Being left alone can be very emotional and stressful. It can be a difficult experience. But this fear of being isolated is
not only exclusively felt by human beings. Animals are no exception. Even dogs, considered to be man’s best friend, suffer
the same emotional predicament.
Dogs are naturally social creatures, they are pack animals. Like babies that develop an attachment to their mothers, dogs,
too, develop a very strong bond with their canine female parents. These pups would only want to be with their turf, where the
mother or father can guard them or provide food through the female dog’s mammary glands. But once this canine family
attachment is dissolved, the dog immediately turns its attention to their owner or caretaker.
Dogs that become too dependent on their owners also do not want to be left alone. When dogs are left alone by their owners,
they become really upset. As “dog depression”upset sets in, they become restless and even destructive This condition is
called Separation Anxiety.
Separation anxiety in dogs is one of the most common canine behavioral problems encountered by veterinarians and seasoned dog
breeders. Dogs can develop separation anxiety much faster if they do not have enough “socialization”. It can also occur if
a dog is repeatedly transferred from one owner to another. Dogs that came from animal shelters and dogs that experienced
traumatic events such as being in the house during a fire, during a burglary attempt, or while an alarm system sounded may
show signs of anxiety.
A dog suffering from separation anxiety will become extremely anxious and distressed. Some signs of distress in your dog may
include any of the following:
· Excessive barking and whining when left alone
· Incessant chewing on variety of things and destroys objects
· Urinate, defecate and vomit in different locations in the house.
· Demands too much attention from you when you are at home
· Gets overly excited when you return home
Dogs that fail to cope with a sudden change in environment may also develop separation anxiety. It is often difficult to
treat this condition because the behavior only occurs when the owner is not around. It can also be alarming when the owner
leaves for an extended period of time.
Experts say that there are medications that can suppress anxiety. These are often used on dogs with severe separation anxiety
or when owners simply must leave the dog alone for an extended period while treatment is being done. The use of drugs allows
the dog to spend extended periods of time free of anxiety. A veterinarian should be consulted for further information about
the use of safe and effective anxiety- suppressing drugs.
These are other ways to reduce separation anxiety in your dog:
· Make arrivals and departures very low key
· Give your dog something to do when he is alone
· Plan your exits
· Leave a radio or TV on so he can listen to human voices when left alone
· Confine your dog in a crate that will also serve him as shelter
· Exercise your dogs
It is important to take immediate measures once you suspect that your dog has this condition. Visit a veterinarian and
inquire about a dog stress treatment program. Keep in mind that your pet’s disorder can be treated and that they also need
proper care and attention. So, if you noticed that your dog is so stuck on you, you might consider taking your “best friend”
to the veterinarian.
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Aug
20
Is the Shock Wave Therapy Inviting Diabetes and Hypertension
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Researchers have found out that
the shock wave treatment provided to the kidney stones patients acts as an
invitation to other diseases like diabetes and hypertension. It has been
discovered that the shock wave treatment is having hazardous side effect as it
increases the risk of diabetes and hypertension in the patients given this
treatment.
Risk for diabetes was related to
the intensity of the treatment and quantity of the shock waves administered;
hypertension was related to treatment of stones in both kidneys. It is found out
that the shock waves lithotripsy uses shock waves to break up the treacherous or
closed kidney stone into smaller, sand like pieces which can be passed
spontaneously, usually within a month. The patient and the instrument that
releases the shock waves both are placed in a water bath. Water allows easier
conduction of the shock waves through the patient’s tissue and precise focus on
the kidney stone.
Mayo Clinic researchers report in
the April issue of the Journal of Urology says that patients who
undergo the procedure, called lithotr
ipsy, are nearly four times more likely to
develop diabetes and face a nearly 50 percent higher risk of high blood pressure
over the following decades than those getting alternative treatment.
The doctors say that they are not
hundred percent sure that the shock wave therapy would lead to theses diseases
in every patient but they have confirmed that there is very high correlation
between the two. The risk of developing diabetes after the shock wave treatment
is almost four times more than the risk among the patients being treated for
kidney stones with the help of medicines. Similarly the risk of developing
hypertension is one and one-half times more than the other group of patients
being treated by medicines.
According to the U.S. National
Institutes of Health, 10 percent of men and 5 percent of women are expected to
develop a kidney stone before the age of 70, and Mayo Clinic experts say that
about 1 million Americans have undergone lithotripsy so far. Further it is
stated that these many people have taken the risk of getting affected by the
other kinds of diseases which they can catch as a result of the treatment or
that are termed as the side effects of the treatment.
Aug
20
To eat or not to eat? It depends on what you gonna do about it
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The United States Department of Agriculture (more commonly known as the USDA) has determined that there is no “one size fits all” plan when it comes to recommending the appropriate caloric intake requirements for individuals. Calories affect each of us differently. Many factors, including sex, age, physical activity levels, genetics, etc., influence the amount of calories we personally need.
Though it is probably impossible to determine (with 100 percent accuracy) the specific caloric intake needs of every individual person without actual medical testing, caloric intake needs can be estimated using a variety of factors.
Most diet related sites will simply tell you that weight gain occurs when we consume more calories than those we burn off. That’s easy enough to understand. So if this is a true fact, then the opposite is also true. If we consume less calories than those we burn off then we will lose weight. Great start! But how do we determine these figures?
How in the world do we know how much we’ve burned off? Most diet sites will tell you that the average person needs anywhere from 2000 to 3000 calories. That’s a pretty big range. How do you know which side of the caloric scale you need to lean towards? The FDA’s MyPyramid program established a food intake pattern table that will help us accurately estimate caloric needs.
They have divided people into two mayor groups: Males and Females. Both the male and female groups are divided into 3 subcategories:1. Sedentary People (moderate physical activity of less than 30 minutes a day)
2. Moderately Active People (moderate physical activity ranges from 30 to 60 minutes a day)
3. Active People. (daily physical activity surpasses 60 minutes)
Each of these 3 categories was further divided by ages. The average caloric intake needs for each category was calculated by age. For minors it was calculated yearly starting from age 2 to 18. According to the MyPyramid list, adult caloric needs only change about every 5 years. So you will have the same caloric need from age 21 to 25, from 26 to 30….from 45 to 50, etc.
So according to the USDA, a 32 year old sedentary male needs 2,400 calories for his daily activities. If he were moderately active he would need 2,600 calories and if he was very active he would need around 3,000 calories.
A sedentary woman of the same age would need 1,800 calories. If her physical activity becomes moderately active she would need 2,000 calories. An active 32 year old woman needs 2,200 calories to remain healthy.
Once we know how many calories we actually need we can then begin working on other areas that will allow us to loose weight. We can determine the amount of physical activity that would be appropriate for our goals and the type of diets we should undertake etc., but all of this should be done when appropriate caloric consumption needs have been established.
Finally, for further discussion of the topic, we advise you to check to the following phentermine forum, which will introduce you to the prominent community of people with the area of interests, which is very close to the subject of this essay.
Aug
20
Allergy Testing Types – What are the different Allergy Testing Procedures
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Allergy testing can help you find out what substances you have an adverse reaction to. Some allergies are very serious, so it is important to undergo an allergy test to figure out just what you’re allergic to. Completing an allergy test can help you find the best ways to treat your symptoms and get on with your life.
The types of allergy testing available varies based on the allergens you are being tested for among other factors.
Prick skin testing is an allergy test where possible allergens are placed on the skin. The skin is then pricked and a period of time passes to see if any of the allergens have caused redness, swelling or irritation. If one of them does, you are most likely allergic to that substance.
Another allergy testing procedure is intradermal skin testing. This type of allergy testing involves the placement of an allergen underneath your skin with a needle. If irritation develops you are most likely allergic to the substance.
Allergy blood testing is another form of allergy testing that can detect your reaction to certain substances. Allergy blood testing is often used when skin testing is out of the question due to an outlying skin condition or for fear of a severe reaction.
Lastly, there is patch skin testing. This allergy test works by placing an allergen on your skin, usually the back, and then covering it with a bandage for many days. If you have a reaction to the allergen, you are most likely allergic and have what is called a contact allergy, or an allergy that is apparent by merely touching the substance in question.
Allergy testing procedures are very effective in determining and diagnosing allergies in all kinds of people. If you think you may be allergic to something, don’t sit around and suffer. You can do something about it. Allergy testing may be the right way to go for you.
Aug
20
It seems that everyone is jumping on the antioxidant bandwagon and why not? New research is coming out all the time that seems to indicate antioxidants can prevent cancer, strengthen your immune system and even keep you from aging. Antioxidants work by sucking up free radicals that can damage your bodys cells and transporting them to the liver where eventually they exit the body.
Heart Disease in particular has been the subject of recent studies. Researchers in Italy examined three hundred and seven middle aged women for Atherosclerosis. This is the formation of plaques and lesions in the coronary arteries, which can signal the development of cardiovascular disease years before a doctor diagnosiss it. These women did not take vitamin supplements containing vitamins A, C or E. The researchers took blood samples to measure the womens baseline level of various antioxidants, took questionnaires and performed ultrasound examinations of their carotid arteries and branches of the heart. They found that women who had plaques building in their arteries had a low intake of vitamin E. Women with the lowest baseline concentrations of Vitamin E in their blood were twice as likely to have plaque build up in their carotid arteries and branches of the heart.
In a side note some promising research has come up relating to breast cancer in women. Researchers gave thirty-two women between the ages of thirty-two and eighty-one with metastasized breast cancer a multivitamin supplement. It contained vitamin C, E, Beta Carotene, selenium, coenzyme Q10 and other vitamins and minerals daily for eighteen months. None of the patients died during this period, which is wonderful because without supplements it could be expected that at least four of the volunteers would have died. Also the cancer in each of the patients appeared t
o stop spreading. Six of the patients showed partial remission. One of the six patients in partial remission had her dosage of coenzyme Q10 increased to 390mg daily and within two months her tumor could no longer be seen on a mammogram.
Antioxidants are beneficial but they seem to be able to do only do so much. In a French study publicized in 2004 it was found that antioxidants tended to benefit men more than women. The Institut National de la Sante et de la Recherche Medicale and Unite de Surveillance et dEpidemiologie Nutritionnelle studied the effects of taking supplements in more than thirteen thousand men and women for seven and a half years. The participants were divided into groups, each one taking a different antioxidant daily. The antioxidants were ascorbic acid, Vitamin E, Beta Carotene, Selenium, Zinc and a placebo. At the end of the study they found that the men who took antioxidants were thirty-one percent less likely to develop cancer than women. Some of us women may be automatically thinking what a sexist finding! While it is possible that antioxidants are simply more effective in men its not probable. It is more likely that the men had a lower baseline of antioxidants in their bloodstream than women, in other words women may have a better diet than men with lots of antioxidants and their baselines were already high. So the antioxidants that men took simply brought the mens baseline up and the antioxidants that women took may have been superfluous.
As a result of this study the researchers suggested that you are able to get a high and beneficial level of antioxidants in your blood with a diet containing lots of fruits and veggies.
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Aug
20
Is This Simple Drink Nature’s Most Powerful Anti-Oxidant
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The news today is all about the extraordinary growth of the Chinese economy, but is there a danger that in importing Western affluence the Chinese may also import our levels of the characteristic diseases of affluence – obesity, diabetes, heart attack, stroke and even cancer?
Perhaps, but probably not, so long as traditional Chinese medicine retains its focus on promoting the balance and harmony of the entire human organism; on unleashing and then harnessing the body’s own incredible healing powers.
The Chinese approach is becoming increasingly popular in the West, but fortunately there’s no need for you wait until you’re ill or to consult a specialist practitioner to derive the benefits. As amazing as it may seem, as simple a change as incorporating a few cups of green tea a day in your routine can deliver dramatic improvements in your well being.
Tea became widely known in China during the Tang dynasty (AD 618–907) but there’s evidence that its health promoting qualities had been known to the enlightened for at least four thousand years.
It was used first as an aid to good digestion, stimulating the absorption of nutrients from food; and also became known as a powerful anti-oxidant and detoxifying agent. These qualities alone, common to all teas, would be more than enough to make it a very valuable health supplement. But there’s much more to green tea than this.
What makes green tea different from the more common black varieties is the method of production. Crucially, leaves for green tea are steamed rather than fermented, preventing the destruction of the vital EGCG compound. If you’ll forgive a little scientific jargon, EGCG is short for Epigallocatechin Gallate, one of a number of catechin polyphenols that occur naturally in tea. EGCG is a very powerful anti-oxidant, the preservation of which has been indicated by research to make green tea anything up to ten times more potent than the more common fermented varieties.
The power of EGCG and related compounds in green tea may be illustrated by comparison with the so-called “French paradox”. Reputable recent research has indicated that the relatively low in
cidence of heart disease in France, despite the traditionally high fat national diet, is due to the significant quantities of resveratrol found in the red wine which is also liberally consumed.
Like EGCG, resveratrol is an anti-oxidant polyphenol, but a 1997 study at the University of Kansas demonstrated that EGCG is up to twice as powerful. Other research has credited EGCG with the ability to reduce total levels of cholesterol as well as improving the ratio of “good” (HDL) cholesterol to “bad” (LDL) cholesterol and protecting against the abnormal blood clotting which is a major risk factor for both heart attacks and strokes – still two of the biggest causes of premature death and disablement in the Western world.
But if there’s one single disease that’s most characteristic of Western society today it must surely be obesity; as a look around your local gym or shopping mall will quickly confirm. And in truth, many of the killer diseases of affluence, most notably diabetes and cardio-vascular problems, have chronic obesity at their root. Swiss research published by the American Journal of Clinical Nutrition in November 1999 suggested that green tea possessed thermogenic properties and promoted fat metabolism at a faster rate than could be explained by its caffeine content alone. Or in layman’s terms, green tea is a powerful fat burner which can be a very useful tool in any weight loss program.
Finally, and perhaps most excitingly of all, there’s increasing evidence that the anti-oxidant effects of green tea may even have positive effects in the fight against cancer. In a major step forward, University of Purdue researchers recently isolated EGCG as the compound responsible, suggesting that the amount contained in as few as four or five cups of green tea a day may inhibit the growth of cancer cells without apparently harming healthy tissue.
Now of course, no one is claiming green tea as a cure for cancer, obesity or any of the conditions mentioned above. But there no longer seems any doubt that just a few
cups a day of this very inexpensive and simplest of drinks can be an invaluable addition to your daily health regime.
Steve Smith
Aug
19
Meditation and the Monkey Mind
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Some find the term, “monkey mind”, upsetting, derogatory, and insulting. This is a shame, as the point is lost, the ego is involved, and a natural human defense goes up. After all, we are supposed to be the “king of the primates,” aren’t we?
The first time I heard the expression, “monkey mind,” in regard to meditation, I thought of Swayambhunath Stupa, in Kathmandu, Nepal. Sometimes, this is named, the “monkey temple,” and it made me laugh inside, as monkeys need supervision in human settings. The picture of unsupervised monkeys got into my head, and I was suppressing laughter during a serious conversation.
Monkeys can be nuisances, when allowed to roam without some guidance, and it is the same with the untrained mind that runs from topic to topic, without getting much accomplished. So please don’t waste time being offended by the term, and try to look at the comical side.
When you allow yourself to enjoy life, and try not to take anything too seriously, you can see that monkeys don’t have it so bad after all. Very often, the human mind spends too much time defending, worrying, posturing, influencing, fearing, and feeling embarrassed, to enjoy life to its fullest potential.
In fact, you are not your mind. You are responsible for your actions, but many things happen in the thought process before you do take action. For example: when you think, images and options are created. As a result of those images, you get a physical feeling somewhere around your heart.
Whether
the feeling is, good or bad, you process it into action, or treat it as a fleeting thought that passes and may be forgotten. So if you have a fleeting evil thought and it passes – should you waste time feeling guilty about it? The natural safeguard for ethical behavior is your heart or “gut feeling.” This is the best indicator of wrong or right.
Mankind has the ability to influence the universe, and create different realities, but separating what is sacred, from what is evil, has been a dilemma for thousands of years. The disconnection from your inner self, nature, and God, has led to excessive confusion.
Thank God for meditation it allows you to harness the power of the mind, settle down, and focus, on one subject at a time. If you take the time for a daily meditation practice, your decision-making process will be much more controlled and clear. The end result will be to look at the monkey with much more respect, appreciation, and a bit of humor.
Paul Jerard, is a co-owner/director of Yoga teacher training at Aura Wellness Center. He has been a certified Master Yoga teacher since 1995. He is a master instructor of martial arts. He teaches Yoga, martial arts, and fitness to children, adults, and seniors. Recently he wrote: Is Running a Yoga Business Right for You? For Yoga students, who may be considering a new career as a Yoga teacher.
http://www.yoga-teacher-training.org
Aug
19
Paget’s Disease – Definition, Causes, Symptoms and Treatment
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Paget’s disease is the second most common bone disease. Paget’s disease is a chronic bone disorder that is due to irregular breakdown and formation of bone tissue.The disease occurs worldwide, but is more common in Europe, Australia, and New Zealand — where it is seen in up to 5% of the elderly population. Paget’s disease can cause bones to expand and weaken and may result in bone pain, arthritis, bone deformity and fractures. Men and women are approximately equally affected. The prevalence of Paget’s disease ranges from 1.5 to 8% depending on age and country of residence. The prevalence of familial Paget’s disease (where more than one family member has the disease) ranges from 10 to 40% in different parts of the world. It is usually localized to one bone, but can involve many bones. The actual cause of Paget’s disease is not known. Paget’s disease is also known as osteitis deformans. The disease may localize to one or two areas within the skeleton, or become widespread. Frequently, bones of the pelvis, leg, spine, arm, or the collar bone are involved. The effect on the skull may enlarge head size and cause hearing loss, if the cranial nerves are damaged by the bone growth.
Paget’s disease may affect only one or two areas of your body, or may be widespread. Paget’s disease tends to appear in families. It can be present in as many as 25 percent to 40 percent of the relatives of someone with the disease. It is also more common in people of Anglo-Saxon descent. Many patients do not know they have Paget’s disease because they have a mild case with no symptoms. Sometimes, symptoms may be confused with those of arthritis or other disorders. Symptoms can arise from the effect on calcium levels in the blood stream. When Paget’s disease is active in several bones, the overactive osteoclasts can release enough calcium from the bone as they break it down to cause an elevated calcium level in the blood. This rare complication might cause fatigue, weakness, loss of appetite, abdominal pain, or constipation. A doctor can also detect Paget’s disease from its effect on the heart if excess blood supply is shunted to overactive bones in severe cases. When pain is severe and unrelenting in an area affected by Paget’s disease, the disease may have degenerated into a bone cancer. Paget’s sarcoma (Figure 6) occurs in only about 1 percent of patients with Paget’s disease. These patients are usually older than 70 years of age. This type of malignant bone tumor is very aggressive and carries a poor prognosis.
Paget’s disease occurs most frequently in the spine, skull, pelvis, thighs, and lower legs. Paget’s disease may be caused by a slow virus infection (i.e., paramyxoviruses such as measles and respiratory syncytial virus). Paget’s disease of bone, though they have discovered several genes that appear to be linked to the disorder. Hereditary factors seem to influence whether you’re susceptible to the disease. Environmental factors may also play a role. Several studies have postulated that viruses, particularly paramyxoviruses such as canine distemper or measles virus, play a role in pathogenesis, but definitive evidence for this is lacking. Presumably, the declining incidence of Paget’s disease reflects a decline in one or more as yet unidentified environmental influences. The SQSTM1/p62 protein is a selective activator of the transcription factor NFB, which plays an important role in osteoclast differentiation and activation in response to the cytokines RANK-ligand and interleukin-1.Mutations in the SQSTM1/p62 gene are therefore a plausible cause of Paget’s disease. Germline DNA mutations (present in every osteoclast) cause bone disease that is focal in nature.
Medical are generally treating Paget’s disease. Treatment include is aspirin, other anti-inflammatory medications, pain medications, and medications that slow the rate of bone turnover, such as calcitonin (Calcimar, Miacalcin), etidronate (Didronel), alendronate (Fosamax), and pamidronate (Aredia). Surgery is used mainly to treat the complications of Paget’s disease. A newer drug, risedronate (Actonel), appears to have a powerful effect against severe Paget’s disease. Miacalcin is administered by injection; 50 to 100 units daily or 3 times per week for 6-18 months. Didronel (etidronate disodium) — Tablet; approved regimen is 200-400 mg once daily for 6 months; the higher dose (400 mg) is more commonly used; no food, beverages, or medications for 2 hours before and after taking. Fosamax (alendronate sodium) — Tablet; 40 mg once daily for 6 months; patients should wait at least 30 minutes after taking before eating any food, drinking anything other than tap water, taking any medication, or lying down (patient may sit). Eating a healthy diet with sufficient calcium and vitamin D and getting exercise are important components in maintaining skeletal health and joint mobility.
Aug
19
Dermatitis Herpetiformis – Definition, Causes, Symptoms and Treatment
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Dermatitis herpetiformis (DH) is a skin disorder often associated with celiac disease. (DH) is an intensely itchy skin eruption. Dermatitis herpetiformis usually begins in persons age 20 and older, although children may sometimes be affected. It is seen in both men and women. It usually shows up in young adults, and is more common in men and people originally from some areas of northern Europe. It has been hypothesized that DH is the result of an immunologic response to chronic stimulation of the gut mucosa by dietary gluten with subsequent activation of cutaneous endothelial cells and circulating inflammatory cells, including neutrophils. DH was formerly described in the literature as Duhring’s Disease. Several chemicals have been associated with induction of DH, including potassium iodide and cleaning solutions. It has a typical onset in the teens or in the third or fourth decades of life. In the U.S., the presence of diagnosed cases is estimated to be about 1 in 10,000 with a male/female ratio of 2:1. It is more common in whites and rare in people of African or Asian descent. If you have DH, you always have gluten intolerance. With DH, the primary lesion is on the skin, whereas with celiac disease the lesions are in the small intestine.
Symptoms of dermatitis herpetiformis are intense burning, stinging and itching around the elbows, knees, scalp, buttocks and back. More locations can also be affected and the severity can vary. Scratching will further irritate the eruptions. Eruptions commonly occur on pressure points, such as around the elbows, the front of the knees, the buttocks, back face, and scalp but can appear anywhere on the body. Eruptions are usually bilateral – occurring on both sides of the body. Ingestion of gluten plays a role in the exacerbation of skin lesions. Small blisters usually develop gradually, mostly on the elbows, knees, buttocks, lower back, and back of the head. Sometimes blisters break out on the face and neck. The rash may be small lumps, like insect bites (papules), some with tiny fluid filled blisters on top. These small blisters are called vesicles. However it can also appear hive-like, persisting in one area, or it may look like a pink and scaly dermatitis. The fact that the rash is most prevalent at pressure points (where clothing rubs the most) may be why the symptoms sometimes appear to be symmetrical. Typically, the onset of DH is in the second to fourth decade; however, persons of any age may be affected.
Derma
titis herpetiformis is frequently associated with gluten (a protein found in cereals) sensitivity in the small bowel. This means that instead of being highly convoluted, the lining of the intestines is smooth and flattened. Gluten is a protein present in grasses of the species Triticeae, which includes barley, rye, and wheat. Rice and oats belong to different species and are generally well tolerated. Hormonal factors may also play a role in the pathogenesis of DH. Androgens have a suppressive effect on immune activity, including decreased autoimmunity, and androgen deficient states may be a potential trigger for DH exacerbation. IgA circulating immune complexes are present in 25-35% of patients with DH, although no association with disease severity has been noted. These immune complexes also have been noted in patients with isolated GSE and are believed to be related to the presence of the gut disease. Associated autoimmune diseases include dermatomyositis, type 1 diabetes mellitus, myasthenia gravis, rheumatoid arthritis, Sjögren syndrome, systemic lupus erythematosus, and thyroid abnormalities. Thyroid abnormalities are present in as many as 50% of DH patients and include hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid cancer.Gastric manipulation (surgery) may induce DH.
There is a very effective treatment available for dermatitis herpetiformis. A gluten-free diet is very difficult to achieve; however, limiting intake of wheat, barley, or rye products can lessen the symptoms. Dapsone can be associated with severe hematologic (blood) disturbances and must be closely monitored. However, strict long-term avoidance of dietary gluten has been shown to reduce the dose of dapsone required to control the disease and may even eliminate the need for medication. In addition, a gluten-free diet may reduce the risk of gastrointestinal lymphoma. Other, less effective treatments for DH include colchicine, cyclosporine, azathioprine, and prednisone. UV light may provide some symptomatic relief. Cyclosporine should be used with caution in patients with DH because of a potential increase in the risk of developing intestinal lymphomas. Nonsteroidal anti-inflammatory drugs may exacerbate DH; however, ibuprofen appears to be safe. Gulphapyridine or sulphamethoxypyridazine have been used to suppress the skin manifestation. It takes several months for the skin to improve on these drugs and they do not protect against the serious complication of gluten hypersensitivity.