The structures formed when IgA attaches to gluten then enter the bloodstream, where they begin to clog small blood vessels, especially those in the skin. White blood cells are attracted to these clogs. Celiac disease can affect anyone, but it tends to be more common in people who have another family member with celiac disease or DH. Although more women than men are diagnosed with celiac disease, men are more likely to develop DH than women, according to the NIH.
The rash usually begins in your 20s or 30s, though it can start in childhood. The condition more commonly occurs in people of European descent.
It less commonly affects people of African or Asian descent. Before a full outbreak of the rash, you may feel the skin in a rash-prone area burn or itch. Bumps that look like pimples filled with clear liquid start to form. These are quickly scratched off. The bumps heal within a few days and leave a purple mark that lasts for weeks.
But new bumps continue to form as old ones heal. This process can continue for years, or it can go into remission and then return. While these symptoms are commonly associated with dermatitis herpetiformis, they can also be caused by other skin conditions such as atopic dermatitis , irritant or allergic contact dermatitis , psoriasis , pemphigoid , or scabies.
DH is best diagnosed with a skin biopsy. A doctor takes a small sample of skin and examines it under a microscope. Sometimes, a direct immunofluorescence test is done, in which the skin around the rash is stained with a dye that will show the presence of IgA antibody deposits.
The skin biopsy can also help determine if the symptoms are caused by another skin condition. Blood tests to check for these antibodies in the blood may also be done.
An intestinal biopsy may be performed to confirm the presence of damage due to celiac disease. If the diagnosis is uncertain, or another diagnosis is possible, other tests may be performed. Patch testing is the best way to diagnose allergic contact dermatitis, which is a common cause of symptoms similar to dermatitis herpetiformis. DH can be treated with an antibiotic called dapsone. Dapsone is a powerful medicine with serious side effects. Dapsone may also have negative interactions with other medications, such as aminobenzoate potassium, clofazimine, or trimethoprim.
Other drugs that may be used include tetracycline, sulfapyridine, and some immunosuppressive drugs. These are less effective than dapsone. This means you should completely avoid food, drink, or medicines containing the following:. If you are adhering to a strict gluten-free diet and are experiencing DH flare ups, consult with a dermatologist expert in celiac disease to determine if foods or medicines high in iodine are the cause. Karpati, S. Dermatitis herpetiformis. Clinics in dermatology 30 1 , International Journal of Dermatology 42 , Iodine Fact Sheet for Health Professionals.
In order to secure increased federal investments in celiac disease research, a group of Celiac Disease Foundation staff members, advocates, and I began a series of detailed conversations in with key Members of Congress and the leadership of the National Institutes of Health NIH.
We learned that a better More information about this medicine is available in the Dapsone patient information leaflet. Some people can't tolerate Dapsone. If you're one of these people, the following drugs can also be taken to clear the rash:. The same associated conditions and complications can occur in people with DH as in people with coeliac disease.
As with coeliac disease, the risk of developing these is reduced by following a gluten-free diet. The British Association of Dermatologists BAD have produced a patient leaflet - Dermatitis Herpetiformis gluten sensitivity - which gives more information about this condition. Home Illnesses and conditions Skin, hair and nails Dermatitis herpetiformis. Dermatitis herpetiformis. How many people have d ermatitis herpetiformis?
DH affects fewer people than coeliac disease, at around 1 in 10, people. DH can appear at any age, but is most commonly diagnosed in those between the ages of 15 and It's more common in men than women and is rare in children.
Symptoms of d ermatitis herpetiformis DH People with DH can have: red, raised patches often with blisters that burst with scratching severe itching and often stinging The rash can affect any area of the skin but is most commonly seen on the: elbows knees buttocks The rash usually occurs on both sides of the body, for example on both elbows.
Causes of d ermatitis herpetiformis DH DH is caused by the body's immune system reacting to a protein called gluten in foods containing wheat, barley and rye. Diagnosing d ermatitis herpetiformis DH A diagnosis of DH is confirmed by a skin test called a skin biopsy.
What is involved in a skin biopsy? Diet before and during diagnosis To ensure an accurate skin test is taken first time, it's important to keep eating gluten-containing foods before and during diagnosis. Gluten-free diet A gluten-free diet is when all gluten-containing foods are removed from your diet Gluten is found in wheat, barley and rye and sometimes people are sensitive to oats too. A gluten-free diet should only start once a confirmed diagnosis of DH is given.
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