What is Dermatitis
Herpetiformis?
It is a very itchy skin rash, which usually occurs on the elbows,
buttocks and knees, although any area of the skin may be affected. The
rash consists of red raised patches and small blisters. There are many
other rashes, which affect the knees and elbows and the diagnosis of
dermatitis herpetiformis is not always easy and should only be made after
examination and tests carried out by a specialist in skin diseases.
Dermatitis herpetiformis is due to gluten sensitivity. Gluten is used
to describe the proteins found in wheat, rye, barley and oats.
In the UK dermatitis herpetiformis is rare in children. The commonest
age when the rash first begins is between I5 and 40 years. However, it may
occur for the first time at any age, even in persons over 70.
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How is it Diagnosed?
Dermatitis herpetiformis is diagnosed by a special skin test. A very
small piece of skin is taken under a local anaesthetic as an outpatient
procedure. The test is carried out on skin NOT affected by the rash.
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Other
associated disorders
In patients with dermatitis herpetiformis the gluten sensitivity also
affects the small intestine as well as the skin, giving rise to Coeliac
disease. In the majority of patients Coeliac disease is mild and may not
cause any obvious symptoms.
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Conventional
treatments
The best treatment is a
gluten-free diet. Not only does this cure the rash, but it also treats the
mild Coeliac disease and, therefore, heals both the skin and the
intestine. It must be stressed that it may take six months before the rash
improves with the gluten-free diet, and nearly two years before the rash
completely disappears.
The rash can be suppressed with tablets within a mailer of days, and it
is usual for patients to be treated with both tablets and a strict
gluten-free diet. The tablets are continued until the diet takes effect.
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How common is
Dermatitis Herpetiformis?
Dermatitis herpetiformis is not
a common skin disease. It is less common than Coeliac disease and the
incidence in the United Kingdom is about I in 20,000 people. There is an
inherited tendency to develop the disease.
Source: -
The Coeliac Society
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