What is dermatitis herpetiformis? Dermatitis herpetiformis is a skin condition that causes very itchy blisters to form under the surface of the skin. The type of blisters caused by dermatitis herpetiformis, also known as DH or Duhring’s disease, are papulovesicular eruptions, meaning that they consist of inflammation and elevations of the skin including sacs or cysts of fluid.
The precise causes of dermatitis herpetiformis symptoms remain unclear, but it is linked to an intolerance to gluten and thus it is often seen as a symptom of celiac disease. Many legitimate sources refer to as a kind of celiac disease of the skin. But other than being an autoimmune response related to gluten in the bloodstream, the precise clinical and medical relationship between gluten intolerance and a dermatitis herpetiformis rash isn’t clear.
Dermatitis Herpetiformis Symptoms
Dermatitis Herpetiformis symptoms typically first appear in the early years of adulthood between 20 and 30 years of age. Patches of very small pink to red blisters initially appear on the back of the neck, buttocks, back and other extensor surfaces. It can be distinguished from other skin conditions by the extremely itchy sensation caused by the disease, leading a patient to have a very strong desire to scratch the affected region. On some occasions, the itchy sensation appears well before the blisters begin to the form. The blisters are full of a watery substance, and the blisters may weep in more severe outbreaks. Dermatitis Herpetiformis is one of the more tangible and most visible gluten allergy symptoms.
I should also warn you about searching for dermatitis herpetiformis pictures. They can be pretty disturbing.
In some cases, Dermatitis Herpetiformis symptoms are cited among gluten allergy symptoms in children and celiac disease symptoms in children. Chronic rashes are definitely a common symptom of both celiac disease and a wheat allergy in children, but there is some debate as to whether this rash is always Dermatitis Herpetiformis or something else.
Diagnosing Duhring’s Disease
To diagnose this skin condition, an experienced dermatologist will take a skin biopsy adjacent to the symptomatic skin. It is important that an experienced dermatologist familiar with the condition conduct this biopsy. Misdiagnosis is common, with an improperly taken biopsy resulting in the diagnosis of linear IgA disease, which is only tenuously associated with sensitivity to gluten.
Dermatitis Herpetiformis Treatment
Dermatits herpetiformis is a chronic condition with symptoms that may persist for some time. Thankfully, there are some treatments that can significantly lessen the symptoms of this condition. Although it is not clear how gluten intolerance is related to this condition, it is clear that a strict gluten-free diet has a positive effect on reducing the severity of DH outbreaks. A gluten intolerance test may help you determine if this is the trigger for your uncomfortable rashes.
Most patients who experience this type of gluten allergy rash will need to make a permanent switch to a gluten-free diet in order to avoid severe DH outbreaks (see my Gluten Free Pantry to get started). The pharmaceutical drug dapsone also has a very high success rate at significantly easing the itchy sensation and blisters associated with DH. It is not entirely clear why dapsone is so effective on treating this condition, as it is simply an antibiotic, and DH is not caused by bacteria. Nevertheless, most patients are able to live comfortably with dermatitis herpetiformis so long as they cut gluten from their diet and administer dapsone as instructed.
If symptoms persist after implementing a strict gluten-free diet, you should discuss the possibility of atopic eczema with your dermatologist. The two skin conditions can co-exist with similar symptoms. Sometimes a particularly stubborn case of DH may indicate the additional presence of atopic eczema.
Dermatitis herpetiformis symptoms remain among the most tangible and evident celiac disease symptoms associated with this nebulous and difficult autoimmune disease.