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Itchy Skin? Celiac Disease and Dermatitis Herpetiformis

Posted Sep 09 2008 2:08am 2 Comments

We all hate to be itchy. Every time I get a bug bite, I scratch my skin until it bleeds because I can’t stand the itchiness! But a bug bite is a small and almost inconsequential ailment compared to what many of us with celiac disease have to endure if we’re one of the few to experience Dermatitis Herpetiformis (DH), a common complication of the autoimmune disease.

Intense blistering, burning, stinging and itching on the knees, elbows, scalp, back and buttocks are some of the most classic symptoms. This all may sound really gross, but don’t worry….DH is genetically determined and is not contagious!

The name, dermatitis herpetiformis, is a descriptive name and is not related to either dermatitis or herpes, but is a specific chronic skin condition. The rash may occur in the form of small lumps, like insect bites and in some cases form fluid filled blisters. These small blisters are called vesicles. However, the rash may appear hive-like, persisting in one area or another. DH can flare and subside even without treatment. When the rash clears up, which it often does spontaneously, it may leave brown pigmentation or pale areas, where pigmentation is lost.

Diagnosis:
Dermatitis Herpetiformis is diagnosed through a blood test and/or a skin biopsy.

Who Gets Dermatitis Herpetiformis and how does it relate to Celiac Disease?
DH affects males more often than females and generally presents in adult life between the ages of 20 and 55. Although it is quite uncommon to find DH in children, cases have been reported.

Not all people with celiac disease develop dermatitis herpetiformis. According to the National Institutes of Health, only about 20 percent of people with DH have intestinal symptoms of celiac disease. However, Australian researchers say that biopsies show that 80% have some degree of villous atrophy.

How is DH Treated?

Like celiac disease, DH is treated with a lifelong gluten-free diet. It may take about six months to achieve some improvement in the skin condition and up to two years or more to achieve total control by sticking to the gluten-free diet alone. This means that the skin response is much slower compared to the healing of the intestines with celiac disease.

Unlike celiac disease, there are a few other treatments for DH that can help relieve symptoms. The rash symptoms can be controlled with medications such as dapsone. However, dapsone does not treat the intestinal condition, meaning that people with DH must also maintain a lifelong gluten-free diet.

More information & References

  • National Institutes of Health (http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/index.htm)
  • The Coeliac Society of Australia (http://www.coeliacsociety.com.au/dermatitis-herpetiformis.htm)
  • Comments (2)
    Sort by: Newest first | Oldest first
    how long after you started on gluten free diet did you start getting some relief?
    I'm soooooooooo glad my rash went away quickly with my change in diet. I had it really badly behind both knees, in the bends of each elbow, behind my ears AND (the WORST) my butt-crack.  It was miserable... Hydrocortisone, Lanacane... NOTHING HELPED! Finding out about my Gluten intolerance was the best thing that ever happened to me!
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