1. The Itch You Can't Escape
Dermatitis herpetiformis, or DH, is a rash that appears on elbows, legs and other parts of the body in little blisters. The most notable thing about DH, however, is the severe itching it causes. Most people affected with dermatitis herpetiformis scratch their skin right off to relieve the itching. These blisters are the first to be scratched off, then the itching is somewhat relieved, if only temporarily. The oozing that follows sometimes creates even more itching.
2. Taking a Sample
Identifying whether or not your rash is dermatitis herpetiformis is a tricky situation. You must have a skin biopsy taken to the lab, where it will show deposits of immunoglobulin A (IgA) in the upper layers of skin if you have this skin disease. You must be on a gluten containing diet for this skin biopsy to be positive and the skin biopsy taken in the correct place for the IgA to be found. Because of this, it's best to see a dermatologist who is familiar with dermatitis herpetiformis and is familiar with your medical history.
3. Protein Problem
Gluten, the protein found in wheat and other grains, is a problem for some people. This protein joins with an anti-body in a gluten sensitive person and causes a dermatitis herpetiformis eruption. Eliminating gluten from the diet helps many individuals, but sometimes drug therapy is necessary. Dapsone improves the symptoms of DH in a fairly short period of time but has many side effects. Close monitoring is a must when starting this drug to limit the possibility of these side effects.
4. A Bit of Blood Rats Out the Culprits
Sometimes a simple blood test shows the likelihood of a dermatitis herpetiformis diagnosis. These blood tests will include a complete metabolic panel (CMP) and a complete blood count (CBC), which shows if you are not absorbing the nutrients in your food. But the most important blood tests are for the antibodies such as anti-gliadin, anti-reticulin and anti-endomysial, which actually cause the skin reaction.
5. Going Down the Gut
If your blood sample shows an increase in the amount of antibodies in your blood, your doctor can usually say you have a gluten sensitivity from this test. This also shows an increased risk of celiac disease, and you not only will get a skin biopsy, but you may be asked to get a small bowel biopsy as well. This procedure, done under mild sedation, uses a small tube camera inserted in your mouth and down your throat, so no scarring is involved. You'll need to be on a gluten containing diet when you do these biopsies to get the most accurate results, but if you've just recently been taken off gluten, your test may still be positive.
