Dermatitis Herpetiformis
These are very long words and difficult to pronounce, so many people refer to it simply as DH (pronc: derma-tight-is and her-pet-a-form-is).  DH is a form of celiac disease that manifests itself through the skin.  It is believed that approximately 10-20% of individuals with celiac disease have this condition but they typically do not have digestive symptoms (although they can).

Ingesting gluten (the protein in wheat-rye-barley) will trigger an immune reaction which deposits IgA (Immunoglobulin A) under the top layer of the skin.  IgA is present in both affected and unaffected areas of the skin.

DH is a permanent lifelong condition, as is celiac disease, and requires a gluten-free diet.

What are the Symptoms?

The individual with DH has skin rashes that produce intense itching and burning sensations.  This is knees. However, it can manifest anywhere (hands, fingers, face, scalp, etc.).

The itching and burning sensations can be very disruptive to everyday life. Scratching only causes further irritation and could also cause scarring.  

As noted above, individuals with DH may or may not have digestive symptoms typical of celiac disease.  

How Do I Get Diagnosed?

The typical blood test for celiac disease may or may not indicate dermatitis herpetiformus since about 30% of DH patients do not produce tTG antibodies.  The gold standard for diagnosing DH is a skin biopsy of unaffected skin near an eruption.  The presence of IgA deposits under the skin, as noted above, confirms a diagnosis of dermatitis herpetiformis. This procedure should be done by a knowledgeable Dermatologist.

How is Dermatitis Herpetiformis Treated?

You must strictly adhere to a gluten-free diet!  Refer to our page on the gluten-free diet to get started.  There are also medications available to help relieve the itching and burning of the skin.  Also, you can have skin flare ups even though you are adhering to the gluten-free diet because of the buildup of IgA over the years.  It will two or more years for the IgA to totally dissipate under the skin and symptoms disappear.  Be patient and persevering!  

“If you have a positive diagnosis of dermatitis herpetiformis, you have celiac disease.  And you must adhere to a gluten-free diet no matter how “normal” your intestine may appear.”  Dr. Peter Green, Celiac Expert, Columbia Unversity & author of Celiac Disease: A Hidden Epidemic
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