Dermatitis Herpetiformis (DH), also commonly refered to as Celiac Skin, is a rare skin disease which is commonly found in people with Celiac Disease. Some quick research on the subject unveiled a few interesting things.
Here is what I’ve learned so far about DH:
What are the Causes of Dermatitis Herpetiformis?
The rash is caused when gluten in the diet combines with IgA, and together they enter the blood stream and circulate. They eventually clog up the small blood vessels in the skin, which attracts white blood cells (neutrophils), and releases powerful chemicals called complements. This is how the rash is created. Iodine is required for the reaction, so people with DH should avoid using Iodized salt if possible.
What are the Symptoms of Dermatitis Herpetiformis?
The 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 depending on the person.
What Does Dermatitis Herpetiformis Look Like?
DH looks like small clusters of red, itchy bumps. There are tiny water blisters, but these are quickly scratched off. Before they form, the area usually has a burning feeling. They scab and heal over within 1-2 weeks, but new spots continue to appear. DH is a lifelong condition, but remission may occur in 10 to 20 percent of patients.
What are the Tests for Dermatitis Herpetiformis?
Diagnosis of DH usually requires at least one skin biopsy, and sometimes a blood test (looking for anti-gliadin, anti-reticulin and anti-endomysial antibodies).
How Do You Treat Dermatitis Herpetiformis?
Complete elimination of gluten will often cure DH, but improvement often takes months. This means suffers must follow a strict gluten free diet. Cutting down on wheat and gluten may reduce the amount of medication needed, but will not be curative.
In the meantime, there is a very effective treatment available to sufferers of DH. Dapsone is a drug that will improve DH in only a few days. Because there can be side effects, the dose of Dapsone is usually started at a small amount, and then raised up over a few weeks until all symptoms are suppressed. Dapsone may have adverse effects, so weekly or bi-weekly blood tests will be needed for the first three months. There are a few alternative treatments if Dapsone cannot be used (sulfapyridine, tetracycline), however these do not work as well.