If you have gluten-sensitive enteropathy, or celiac disease, foods that contain the protein gluten cause a myriad of symptoms, including diarrhea, bloating, weakness and tingling, when consumed. You may also experience a serious, painful rash as a result of gluten intolerance. Called dermatitis herpetiformis, this gluten-sensitive hereditary skin rash produces painful, itchy skin lesions most commonly on the elbows, knees and buttocks, but can occur anywhere on the body, usually on both sides, according to Elaine Hartsook, Ph.D., former director of the Gluten Intolerance Group of North America. People with dermatitis herpetiformis always have celiac, but not everyone with celiac experiences the rash.
About
Dermatitis herpetiformis is characterized by groups of blistering red bumps. They cause your skin to itch intensely and when you scratch, it bursts the blisters, causing them to crust over. The rash is an autoimmune response to gluten consumption -- but why some people develop it and others do not is not known.
Diagnosis
The rash typically appears between the ages of 15 to 40 years, but some younger children may develop it. The reason why diagnosis occurs most commonly at these ages is not clear. Both men and women can develop the condition. To diagnose your rash as dermatitis herpetiformis, your doctor will take a biopsy near the rash to identify a specific antibody that indicates gluten intolerance. You may also undergo blood tests and an intestinal biopsy to confirm a diagnosis of celiac disease. Many people with dermatitis herpetiformis do not have serious digestive symptoms which are hallmarks of celiac disease.
Treatment
Your doctor may initially prescribe a sulfa-based medication, such as dapsone or sulfapyridine, to alleviate symptoms. The primary treatment for the rash is a strict gluten-free diet. You will be required to avoid all foods containing wheat, barley and rye, along with derivatives of these foods. Traditional bread, cereal, pasta, pizza, beer and soy sauce are just some of the foods you need to avoid. Fresh fruits, vegetables, rice, quinoa, lean meats, eggs and dairy are all gluten-free foods that you can still enjoy. As the gluten-free diet helps your body heal, you may be able to decrease your dosage of medication.
Considerations
Although the name of the rash comes from dermatitis, which means inflammation of the skin, and herpetiformis, because the rash looks like herpes, it has no connection to the herpes virus. If you leave the rash and your celiac disease disease untreated, you may develop additional health complications, including cancer, osteoporosis and other autoimmune conditions.
References
- Medline Plus: Dermatitis Herpetiformis
- "Living Gluten-Free For Dummies"; Danna Korn; 2006
- The University of Chicago Celiac Disease Center: What Are the Symptoms of Celiac Disease?
- "Nutrition Factsheet"; Gluten Intolerance; Elaine Hartsook, Ph.D.; 1992
- The Dermatitis Herpetiformis Online Community; What Is Dermatitis Herpetiformis? Lionel Fry; Summer 2001
