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Dermatitis herpetiformis

What is dermatitis herpetiformis?

Dermatitis herpetiformis (DH) is a skin condition associated with coeliac disease and there is growing evidence that it is a skin symptom of coeliac disease. This skin condition effects 1 in 10,000 people.

Symptoms

Dermatitis herpetiformis skinDermatitis herpetiformis is characterised by an itchy, blistering skin rash which usually occurs on the knees, elbows, buttocks and back, however, it can affect any area of the skin.

Prevalence

In the UK about 1 in 10,000 people are diagnosed with Dermatitis Herpetiformis which makes it less common than coeliac disease. It most commonly presents between the ages of 15-40 years, also it tends to be more common in men than women.

Diagnosis

Diagnosis is confirmed by a simple skin test called a skin biopsy. A dermatologist (skin specialist) takes a small sample of skin from an unaffected area. This is then checked for the presence of an antibody called Immunoglobulin A (IgA).

If the skin biopsy is positive, you should be referred to a gastroenterologist (gut specialist) for a gut biopsy. This is called an endoscopy and is the same test used to confirm a diagnosis of coeliac disease.

Even though you may not have gut symptoms, most people with Dermatitis Herpetiformis have gut damage. It is important not to remove gluten from your diet until the antibody blood tests and biopsy have been carried out to ensure an accurate result.

If you have already removed gluten from your diet, you
must re-introduce it for at least six weeks, consuming gluten at more than one meal every day, before the diagnostic tests are performed.

Dermatitis herpetiformis viewed under the microscope

How is dermatitis herpetiformis treated?

A gluten free diet is the main form of treatment and the most effective in the long-term, however the time taken for the skin rash to improve varies between individuals. It is common to have a drug treatment initially; the most commonly prescribed drug is called Dapsone. It will help to control the rash. However the rash may reappear if the drugs are discontinued before a gluten free diet has been adopted and taken effect. It often can take up to six months for the dose to be reduced.

Fortunately there are now many different types of delicious gluten free foods available on prescription, for treatment of dermatitis herpetiformis.  See our product pages here.

If you have any questions about dermatitis herpetiformis please contact us here

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