Dermatitis Herpetitformis

Dermatitis Herpetitformis is a chronic disease of the skin marked by watery, itchy blisters that may resemble pimples or blisters. The ingestion of gluten (from wheat, rye and barley) triggers an immune system response that deposits a substance, IgA (Immunoglobulin A), under the top layer of the skin. IgA is present in affected as well as unaffected skin. Dermatitis Herpetitformis is a hereditary autoimmune gluten intolerance disease linked with celiac disease. If you have Dermatitis Herpetitformis you will always have gluten intolerance. With Dermatitis Herpetitformis, the primary lesion is on the skin, whereas with celiac disease the lesions are in the small intestine. The degree of damage to the small intestine is often less severe or more patchy than those with celiac disease. Both diseases are permanent and the symptoms and damage will occur after eating gluten.

The symptoms of dermatitis herpetitformis are:

• Watery, itchy skin that resembles pimples or blisters
• Itching and burning sensation
• Scratching will irritate it more
• May appear on pressure points, such as, elbows, knees, buttocks, face and scalp, but can appear anywhere.
• Can effect men, women and children

The diagnosis of dermatitis herpetitformis is to have your dermatologist take a small biopsy of the unaffected skin. The presence of IgA deposits will confirm a diagnosis of Dermatitis Herpetitformis. Sometimes the dermatologist may also want you to do blood work for celiac disease and see a GI Doctor.

The treatment for dermatitis herpetitformis is to strictly follow a gluten free diet. It may take a two years or more on a gluten free diet for the IgA deposits under the skin to clear. Your doctor may prescribe medications for relief from the itching and burning, it requires close monitoring by your doctor (because of serious side effects). Medications should not be used during pregnancy. If you are using medications to relieve the itching make sure you are also following a gluten-free diet.

The questions you should ask your doctor are:

• Should I be taking medications for this disease?
• How long should I take this medicine?
• What are the side effects of the medicine?
• How often do I need to get my blood drawn?
• What else can trigger Dermatitis Herpetitformis?

The Prognosis is excellent if you stay on the gluten free diet. The severity and frequency of the itching and burning will decrease as you continue on with the gluten free diet. Iodine is essential and should not be removed from your diet without your doctor's supervision.

The related disorders with Dermatitis Herpetitformis and Celiac Disease are:

• Thyroid disease (most common)
• Addison's disease
• Autoimmune chronic active hepatitis
• Alopecia Areata
• Graves disease
• Insulin-Dependant Diabetes mellitus (type 1)
• Myasthenia gravis
• Scleroderma
• Sjogren's syndrome
• Systemic lupus erythematosus
• there may be other diseases associated

Thyroid disease and diabetes are the two most commonly associated diseases. You may have other skin conditions as well.