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 as Duhring’s disease, causes blisters that look like herpes, but the condition doesn’t come from the herpes virus. It’s linked to gluten sensitivity.
Dermatitis Herpetiformis Causes and Risk Factors
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. You’re more likely to have it if one of your parents or a brother or sister does too. It’s most common in people of European descent and rare in people of African or Asian heritage.
Dermatitis Herpetiformis 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:
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. It takes 1-2 weeks for your blisters to scab over and heal, but new blisters often grow in their place.
The same response to gluten that’s affecting your skin may also damage your small intestine. That can cause digestive symptoms including:
Sometimes, DH can even affect the enamel on your teeth.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.
Dermatitis Herpetiformis Diagnosis
Your doctor will need to do a skin biopsy. After numbing the area, they’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. They can then also take some of your blood to test it for celiac disease.
Dermatitis Herpetiformis Treatment and Home Remedies
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 is important, but it’s only part of the solution. In most cases, you’ll also need to take medicine to get full relief.