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Dermititis Herpetiformis

What is Dermatitis Herpetiformis?

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Dermatitis herpetiformis, also known as DH or Duhring’s disease is a chronic, intensely itchy, blistering skin condition which is also caused by an immune reaction to ingesting gluten. It may or may not be associated with other coeliac disease symptoms, but is linked to coeliac disease. The name herpetiformis is derived from the tendency for blisters to appear in clusters, resembling herpes simplex. However, dermatitis herpetiformis is not due to this viral infection. Everyone with DH also has coeliac disease.

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SYMPTOMS OF COELIAC DISEASE

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What are the symptoms?

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Dermatitis Herpeformis is a rash most commonly occurring on the elbows, knees, shoulders, buttocks, and face. It’s categorised as red, raised patches, often with blisters.
Diagnosis
Diagnosis is confirmed by a skin biopsy. A dermatologist takes a skin sample which is checked for the presence of an antibody called immunoglobulin A (lgA). If the antibody is found, this means the skin biopsy is positive and you should be referred to a gastroenterologist (gut specialist) for further testing. This is because of the link with coeliac disease.

Treatment

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The treatment for DH is a life-long gluten free diet. Although this is effective in the long-term, it can take an average of two years for it to take full effect, so drug treatment may also be recommended to begin with. The most commonly prescribed drug for DH is Dapsone. This will help control the itching and development of blisters, although the rash will come back if you stop taking it before the gluten free diet has taken effect.

For further information, please download our pdf on Dermatitis Herpetiformis.

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Does Dermatitis Herpeformis increase the risk of other diseases?

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As with coeliac disease, DH is also associated with an increased risk of other autoimmune diseases such as thyroid disease or Type 1 diabetes. The complications that occur in coeliac disease can also occur in DH: these include osteoporosis and certain types of small bowel cancer. Once you have been following the gluten free diet for some time, the risk of osteoporosis is reduced and the risk of cancer becomes the same as someone who doesn’t have coeliac disease or dermatitis herpetiformis.

This information is for guidance only and should not replace advice given by your medical professional

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TREATMENT

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Coeliac disease is treated by a life-long gluten free diet. By specifically removing the cause of the disease, this treatment allows all abnormalities to recover completely. As long as the diet is adhered to strictly, patients can recover.

An initial few weeks on both a gluten/lactose free diet will allow the bowel lining to replace its 'lactase' enzyme quantities, which digest lactose sugar prior to absorption. This may take longer for some individuals than others.

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