People with celiac disease are allergic to gluten, the protein complex found in certain grains, cereals and breads. While this condition primarily causes reactions in the gut, a secondary form of the disease that affects the skin can develop in some people. There is no cure, but with treatment and diet modifications, symptoms can be managed. Talk to your doctor about your treatment options to ensure the best prognosis.
General Symptoms
Symptoms of gluten allergy in the skin generally include a red, intensely itchy rash accompanied by fluid-filled blisters of varying size. While these blisters can appear anywhere on the body, they most frequently occur symmetrically on the scalp, knees, elbows, buttocks or across the back or neck.
Dermatitis Herpetiformis
Also called Duhring's disease, dermatitis herpetiformis is an autoimmune response attributed to gluten intolerance. According to the National Center for Biotechnology Information, skin-related gluten reactions affect men and women equally and most commonly start to affect people 20 years of age or older. Characterized by rash and other inflammations of the skin, atopic dermatitis triggered by gluten allergy is a chronic condition, meaning it is ongoing. In an article published by “American Family Physician,” Harold T. Pruessner, M.D., notes that this skin disease affects about 5 percent of all people with celiac disease and may be the first sign of the disease in 20-to-30-year-olds.
Other Skin Conditions
Other skin-related disturbances are possible with gluten reactions, including angular cheilitis, aphthous ulcers and alopecia. The first two conditions are restricted to the mouth. Aphthous ulcers, more commonly known as canker sores, occur on the inside lining of the mouth or at the base of the gums. Angular cheilitis, also called angular stomatitis, typically manifests as sores or cracks at the corners of the mouth. Alopecia, or hair loss, may be partial or complete.
Diagnosis
In addition to a visual inspection of skin lesions, your physician may conduct a skin biopsy and blood tests to determine how much immunoglobulin A and immunoglobulin G are present in the skin and blood. Also expressed as IgA and IgG, a measurement of these antibodies is a reliable marker of celiac disease and secondary skin diseases.
Treatment
The first course of action to manage symptoms is to adhere to a gluten-free diet. This means becoming astute at reading food labels and tenaciously asking about ingredients when dining out. For some people, this is enough; for others, antibiotic therapy or immunosuppressive medications may also be necessary. Consult your physician for further dietary guidance. You might also consider enlisting the aid of a registered dietitian and joining a celiac support group.
