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Dermatitis herpetiformis

Definition

Dermatitis herpetiformis is a chronic, extremely itchy rash consisting of bumps and blisters. Dermatitis herpetiformis is linked to sensitivity of the intestine to gluten in the diet (celiac sprue).

Causes, incidence, and risk factors

Dermatitis herpetiformis usually begins in persons 20 and older, though children may sometimes be affected. It is seen in both men and women.

Though the cause of the rash is unknown, dermatitis herpetiformis is frequently associated with gluten (a protein found in cereals) sensitivity in the small bowel.

Symptoms

Dermatitis herpetiformis is usually extremely itchy. The bumps or blisters usually appear on the elbows, knees, back, and buttocks. In most cases, the rash is the same size and shape on both sides. Symptoms of dermatitis herpetiformis tend to get worse and get better.

Signs and tests

A skin biopsy and direct immunofluorescence test of the skin are performed in most cases. Your doctor may also recommend a biopsy of the intestines.

Treatment

Dapsone, an antibiotic, may help most patients.

A strict gluten-free diet will also be recommended to help control the disease. Sticking to this diet may remove the need for medications and prevent later complications.

Support Groups

The Celiac Sprue Association may offer support for people with dermatitis herpetiformis.

PO Box 31700, Omaha, NE 68131, (402) 558-0600

www.csaceliacs.org

Expectations (prognosis)

The disease may be well controlled with treatment.

Complications

Thyroid disease may be found in many patients with dermatitis herpetiformis. Patients are also more likely to develop certain cancers of the intestines.

Calling your health care provider

Call your physician if you develop an itchy rash or diarrhea.

Prevention

There is no known prevention of this disease. Avoidance of gluten-containing foods will help prevent complications in affected patients.