Dermatitis herpetiformis (DH), also known as the “gluten rash,” is “a blistering, intensely itchy skin rash.” Usually symmetrical in shape, it’s most commonly located on the elbows, scalp, knees, buttocks, and upper back. According to the American Osteopathic College of Dermatology (AOCD), people can experience the rash on other parts of the body and severity can vary.
The AOCD describes the basic DH cycle, which usually consists of a burning feeling on the affected area, followed by water blisters which tend to get scratched off, followed by scabbing and healing, which takes one to two weeks, then a new outbreak of these bumps or blisters. According to the AOCD, “DH is a lifelong condition, but remission may occur in 10 to 20 percent of patients.”
Celiac patients with DH also often experience mild or no gastrointestinal issues, although villous atrophy will most often still be present. Some people with DH show the signs of celiac disease, although some people just exhibit DH without the characteristic gut symptoms of celiac disease.
Diagnosis usually requires a skin biopsy and sometimes specific blood tests, and the treatment is the gluten-free diet. Once you’ve completely eliminated gluten from the diet, an alleviation of the rash can take months. Drug treatment can also be used to suppress symptoms. Dapsone can cause an improvement in DH “in days, ” according to the AOCD.
The drug does have side effects, and for this reason, treatment begins with small doses of the drug, gradually increased until the symptoms disappear. Due to the side effects of Dapsone, blood tests will be conducted weekly or bi-weekly for the first three months of treatment. A few other alternative drug treatments are available, such as sulfapyridine and tetracycline, in case Dapsone doesn’t work, although these other drugs aren’t as effective.
From our home to yours, Tina Turbin
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