Dermatitis Herpetiformis

Dermatitis Herpetiformis (DH) is an autoimmune skin disorder that is related to Celiac Disease - both of which are linked to a sensitivity to glutens (proteins in wheat, rye and barley products).

Up to 90% of people with DH also have a gluten-sensitive enteropathy (GSE – abnormality of the small bowel). DH is rare and estimated to be around one (1) case in 10,000 people. Men seem to be more likely than women to develop the disease. Persons of any age can exhibit DH symptoms; however, people between 20 – 40 years of age are more likely to be affected.

Symptoms

The primary DH symptom is an extremely itchy, burning rash containing both bumps (e.g. hives) and blisters. The blisters develop gradually, usually on the elbows, buttocks, shoulders, lower back, knees and back of the head, but can also appear on the face and neck.

Taking ibuprofen (anti-inflammatory drug) may worsen the condition. DH is a life-long disease with corresponding periods of exacerbation and remission.

Causes

The cause of dermatitis herpetiformis is linked to an immune system response and related sensitivity to gluten (a type of protein found in wheat, rye and barley). In most cases, people that have DH, also have gluten-sensitivity enteropathy (also termed Celiac Sprue Disease). Genetic predisposition to this sensitivity is a major factor, as is a higher incidence of other autoimmune diseases, such as thyroiditis, sarcoidosis and diabetes.

Treatment

Treatment, although limited is usually quite effective. A gluten-free diet is absolutely mandatory, so all foods containing these proteins must be avoided. In addition, the drug dapsone (antibiotic) is usually prescribed and can offer relief from DH symptoms within a few days. However, this drug does pose some dangers and blood counts are usually closely watched.

In most cases, after about six (6) months on the gluten-free diet, drug therapy can be discontinued. However, any reexposure to gluten will almost always trigger a recurrence of DH symptoms. If left untreated, DH may result in a significant risk of developing intestinal cancer.

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