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Dermatitis Herpetiformis

Dermatitis herpetiformis (DH) is not a skin allergy. Rather, DH is a chronic, extremely itchy rash consisting of papules and vesicles. Although it is often confused with skin allergies, it is actually associated with Celiac Disease (CD), a sensitivity of the intestine to gluten foods in the diet. CD is also not a foold allergy, but rather a disease of the intestines.

DH (also called “Duhring’s Disease”) usually begins in the twenties, though children may sometimes be affected. It is seen in both men and women. Though the cause of the rash is unknown, dermatitis herpetiformis is frequently associated with gluten (a protein found in cereals) sensitivity in the small bowel.

Dermatitis herpetiformis is usually extremely itchy. The vesicles or papules usually appear on the elbows, knees, back, and buttocks. In most cases, it is highly symmetric. Symptoms of dermatitis herpetiformis tend to wax and wane. A skin biopsy and direct immunofluorescence test of the skin are performed in most cases. Your doctor may additionally recommend a biopsy of the intestines.

Dapsone, an antibiotic, may help the majority of patients. A strict gluten-free diet will also be recommended to help control the disease. Adherence to this diet may eliminate the need for medications and prevent later complications. The disease may be well controlled with treatment. Thyroid disease may be found in many patients with dermatitis herpetiformis. Patients are also more likely to develop certain cancers of the intestines.

Call your physician if you develop an itchy rash or diarrhea.

There is no known prevention of this disease other than avoidance of foods with gluten to help prevent complications in affected patients.

 

SOURCE: This information should not substitute for seeking responsible, professional medical care. First created 1995; fully updated 1998; most recently updated 2005.
© Asthma and Allergy Foundation of America (AAFA) Editorial Board

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