What Is Dermatitis Herpetiformis?

Dermatitis herpetiformis (DH) is a bumpy, itchy skin rash that’s common in people with celiac disease. That’s an autoimmune disorder that keeps your body from digesting gluten, a protein found in wheat and other grains.

DH, also known Duhring’s disease, causes blisters that look like herpes, but the condition doesn’t come from the herpes virus. It’s linked to gluten allergies.

What Causes It?

If you have celiac disease and eat gluten, your intestines make an antibody called IgA in response. This chemical flows into your bloodstream and builds up in blood vessels under your skin. It triggers the DH rash.

This condition is rare in children. It usually shows up for the first time when you’re between 30 and 40 years old. Men tend to get it more often than women. It’s most common in people of European descent and rare among African-Americans and Asian-Americans.

What Are the Symptoms?

The first thing you’ll probably notice is a burning or stinging sensation on certain places on your skin. After that, clusters of small, red bumps pop up. They’re very itchy, and can take several forms, like:

  • Blisters
  • Fluid-filled sores
  • Sores that look like hives
  • Raised sores

You may mistake your bumps and blisters for eczema. Most often, DH shows up on your:

You can also get them in other places on your body, like your neck, face, or groin. Usually, they show up on both sides of your body at once. Sometimes, DH can even affect the enamel on your teeth.

It takes 1-2 weeks for your blisters to scab over and heal, but new blisters often grow in their place. Symptoms can die down and flare back up over time. Once you get DH, you usually deal with it for the rest of your life.

How Is It Diagnosed?

Your doctor will need to do a skin biopsy. After numbing the area, he’ll use a very small instrument that works like a cookie-cutter to “punch” out part of your skin. You may need a stitch or two to close up the site. It should heal quickly, with very little scarring.

A lab will use dye to see if you have IgA in a certain type of pattern. This tells your doctor whether you have DH. He can then also take some of your blood to test it for celiac disease.

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How Is It Treated?

There’s no cure for DH, but medications can help heal your rash. Your doctor might prescribe dapsone, which you take by mouth. It gets rid of your itching and bumps within 1-3 days. Your doctor may also recommend a topical corticosteroid cream to help with itching.

If tests show that you have celiac disease, your doctor will tell you to completely cut gluten out of your diet. Iodine, a common ingredient in salt, can make symptoms worse in some cases. So you may need to avoid that, too.

A gluten-free diet important, but it’s only part of the solution. In most cases, you’ll also need to take medicine to get full relief.

WebMD Medical Reference Reviewed by Debra Jaliman, MD on September 26, 2016

Sources

SOURCES:

Celiac Disease Foundation: “Dermatitis Herpetiformis.”

National Institute of Diabetes and Digestive and Kidney Diseases: Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease.”

National Organization for Rare Disorders: “Dermatitis Herpetiformis.”

American Osteopathic College of Dermatology: “Dermatitis Herpetiformis.”

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