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Dermatitis Herpetiformis, The 'Gluten Rash'

Some People Call It The 'Celiac Disease Rash'

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Updated April 02, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Dermatitis herpetiformis, an itchy, stinging, blistering skin rash, occurs when your skin reacts to gluten antibodies circulating in your system. Some people call dermatitis herpetiformis a "gluten rash" or a "celiac disease rash" because it occurs in conjunction with celiac disease.

Although dermatitis herpetiformis can form anywhere on your body, the most frequent locations include the elbows, knees, buttocks, lower back and the back of the neck. In most cases (but not all), it's one of the itchiest skin conditions you can experience.

Dermatitis Herpetiformis Symptoms

Dermatitis herpetiformis sufferers usually experience their rashes in the same location every time. The rash might be continuous, or it might come and go.

Before the actual dermatitis herpetiformis rash breaks out, your skin may itch in that location, or it might feel as if it's burning. The rash itself usually includes reddened skin plus multiple small, pimple-like bumps, which contain a clear liquid.

The dermatitis herpetiformis bumps usually take several days to heal (during which time new bumps usually appear nearby), and once healed, will leave behind small purple marks that last for weeks or months. People with long-standing dermatitis herpetiformis usually have continuously reddened skin where their rash occurs.

Who Does Dermatitis Herpetiformis Affect?

Unlike celiac disease, which is diagnosed more often in women, dermatitis herpetiformis is more common in men. In fact, some studies show a male-to-female ratio of up to 2-to-1 in dermatitis herpetiformis patients.

Dermatitis herpetiformis is rare in children younger than age 10. It typically first surfaces in your teens, 20s or 30s, and it sometimes goes into remission even if you're eating a gluten-filled diet.

About 15% to 25% of celiac disease patients also have dermatitis herpetiformis. Although many dermatitis herpetiformis patients don't have overt intestinal symptoms, 90% will have intestinal damage from gluten consumption.

Dermatitis Herpetiformis Diagnosis

Dermatitis herpetiformis is diagnosed through a skin biopsy procedure that looks for specific deposits of antibodies beneath the skin. A dermatologist usually performs the in-office procedure, which involves taking a small sample of skin.

Dermatitis Herpetiformis and Celiac Disease

In most cases, being diagnosed with dermatitis herpetiformis means you also have celiac disease, even if you don't have classic or overt intestinal celiac disease symptoms.

Dermatitis Herpetiformis Treatment

Although a medication called dapsone can offer some initial relief from the itching associated with dermatitis herpetiformis, it carries long-term side effects. Therefore, the only long-term treatment to keep your dermatitis herpetiformis at bay is the gluten-free diet.

Other Skin Conditions Associated with Celiac Disease

Dermatitis herpetiformis is common among celiacs, but it's far from the only skin condition associated with celiac disease and antibodies to gluten. Eczema, psoriasis, alopecia areata, hives and even acne all have been linked with celiac disease.

Sources:

Dermatitis Herpetiformis. American Osteopathic College of Dermatology. Accessed Jan. 13, 2011.

J.A. Miller. Dermatitis Herpetiformis. eMedicine review, accessed Jan. 13, 2011.

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