Dermatitis Herpetiformis is the skin manifestation of Celiac. It is a life-long condition which can affect any part of the body, but most commonly appears as a rash on the elbows, knees, scalp, back of neck, shoulders, upper back and buttocks, and in the mouth, though more uncommon. The rash generally appears symmetrically (both arms, both knees, etc.) and is characterized by intensely itchy groups of lesions. One must be gluten-sensitive to develop Dermatitis Herpetiformis. Having other auto-immune disorders increases the risk of developing DH.
Symptoms: intensively itchy, red, raised blisters and bumps less than 1 cm. If scratched, crusting will appear and lesions can burn and sting. Burning and itching may appear in an area, even before the lesions actually appear. DH rashes are often mistaken for psoriasis or other skin conditions. Possibly kelp, potassium iodide, iodized salt and stress can worsen symptoms.
Individuals with DH could have normal tTG levels and no intestinal damage, or intestinal damage can occur.
How Diagnosed: An endoscopy is not required in the diagnosis of DH, a skin biopsy is sufficient. The dermatologist will look for deposits of the immunoglobulin class IgA around the affected skin.
Treatment: In addition to following a strict and life-long gluten-free diet, medications such as Dapsone and other topical cortisone & steroid creams may be prescribed to help with the symptoms. Symptoms will clear if gluten is completely removed from the diet, though healing time may vary. Flare-ups are common. Be sure to consult a knowledgeable dermatologist to confirm a diagnosis of DH, before self-prescribing any medications.
Cosmetics, shampoo and body products containing gluten should be avoided. [See our Store for gluten-free products available.]
Generally, healing of the skin can take longer than intestinal “villi” healing.
To see images of Dermatitis Herpetiformis visit the following sites (caution: some are graphic):
http://www.nlm.nih.gov/medlineplus/ency/article/001480.htm
http://dermnetnz.org/immune/dermatitis-herpetiformis.html
http://gastrolab.net/ng016.htm
http://celiacdisease.about.com/od/commoncomplicationsofcd/a/Dermatitis-Herpetiformis-Photos.htm
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