Dermatitis herpetiformis

Dermatitis herpetiformis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Dermatitis herpetiformis Dermatitis herpetiformis Dermatitis herpetiformis (DH) is an autoimmune skin condition that can be linked to coeliac disease . How many people have dermatitis herpetiformis? DH affects around 1 in 10,000 people. DH can appear at any age, but is most commonly diagnosed in those between the ages of 15 and 40. Its more common in men than women and is rare in children. Symptoms of dermatitis herpetiformis (DH) People with DH can have: red, raised patches often with blisters that burst with scratching severe itching and often stinging The rash can affect any area of the skin but is most commonly seen on the: elbows knees buttocks The rash usually occurs on both sides of the body, for example on both elbows. Dermatitis herpetiformis often affects the knees. Source: https://dermnetnz.org/ Gut symptoms Most people with DH will have the same kind of gut damage seen with coeliac disease, but may not complain of gut symptoms like: diarrhoea constipation stomach pain bloating Just over half (60%) of people with DH dont have gut symptoms. Causes of d ermatitis herpetiformis (DH) DH is caused by the bodys immune system reacting to a protein called gluten in foods containing wheat, barley and rye. This reaction causes a skin rash to develop. Diagnosing d ermatitis herpetiformis (DH) A diagnosis of DH is confirmed by a skin test called a skin biopsy. A skin biopsy is a procedure where a sample of skin is removed to be tested. As DH is strongly linked to coeliac disease, blood tests may be taken for this condition as well. What happens during a skin biopsy test? During a skin biopsy test, a specialist skin doctor called a dermatologist will take a small sample of skin from an area without the rash. Samples of skin taken from the area with the rash dont always give an accurate result. The skin sample is then tested. If you test positive for DH youll be referred to a specialist gut doctor called a gastroenterologist to be tested for coeliac disease. Diet before and during diagnosis To ensure an accurate skin test is taken first time, its important to keep eating foods with gluten before and during diagnosis. If youve already removed gluten from your diet, you must reintroduce it in more than one meal every day. You should do this for at least 6 weeks before having the tests. Treating d ermatitis herpetiformis (DH) The treatment for DH is a lifelong gluten-free diet. A gluten-free diet is when all gluten-containing foods are removed from your diet Gluten is found in wheat, barley and rye and sometimes people are sensitive to oats too. A gluten free diet should only start once the diagnosis of DH is given and a referral to a dietitian has been made. Find out how to live with a gluten-free diet How long does treatment take to work? The length of time it takes for the skin to heal varies from person to person but it can take up to 2 years or more. Medication during treatment Some patients will be given medication to help them over this period of recovery. Medication will only be given to control the skin itching and blisters and doesnt treat any other symptoms. The drug most likely to be used is called Dapsone. Dapsone Dapsone is taken in tablet form and must be swallowed. It helps ease the itching and controls the development of blisters. It should work within a few days. If you stop taking Dapsone before the gluten-free diet has taken effect, the rash will return. Side effects of Dapsone The most common side effect of Dapsone is anaemia . Less common side effects are headaches and depression , while nerve damage is rare. Youll always be prescribed the lowest effective dose to help prevent these side effects. DH should be monitored once the drug dose has been reduced. Alternatives to Dapsone Some people cant tolerate Dapsone. If youre one of these people, the following drugs can also be taken to clear the rash: Sulphapyridine Sulphamethoxypyridazine Complications ofd ermatitis herpetiformis (DH) DH can cause the same conditions and complications as coeliac disease . Some potential complications of DH include: osteoporosis certain kinds of gut cancer an increased risk of other autoimmune diseases, such as type 1 diabetes and thyroid disease As with coeliac disease, the risk of developing these is reduced by following a gluten-free diet. Source: Scottish Government - Opens in new browser window Last updated: 05 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. 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