What is dermatitis herpetiformis?
Dermatitis herpetiformis (DH) is a long-term skin condition linked to gluten sensitivity and celiac disease. It causes an extremely itchy rash made up of small blisters and bumps, often appearing on both sides of the body.
DH happens when the immune system reacts to gluten and creates inflammation in the skin. Many people with DH also have celiac disease, even if they do not have digestive symptoms.
Some factors may increase the risk of developing DH, including:
- Family history of celiac disease
- Autoimmune conditions such as thyroid disease or type 1 diabetes
- Northern European ancestry
Certain triggers, including iodine and some anti-inflammatory medicines, may make symptoms worse in some people.
Symptoms
DH symptoms can come and go over time. Many people notice intense itching or burning before the rash appears.
Common symptoms include:
- Clusters of small blisters or raised bumps
- Severe itching or stinging
- Red, irritated skin
- Scratching that leads to sores or crusting
How is it diagnosed?
A healthcare provider will examine your skin and review your symptoms and medical history. Because DH can look similar to other skin conditions, testing is often needed to confirm the diagnosis.
Diagnosis may include:
- A skin biopsy
- Direct immunofluorescence testing to look for IgA antibody deposits
- Blood tests to check for signs of celiac disease or gluten sensitivity
Your provider may also evaluate for related digestive conditions.
How is it treated?
Treatment for DH focuses on controlling symptoms and reducing immune system reactions to gluten.
A strict gluten-free diet is the most important part of treatment. Avoiding gluten can help the rash heal, lower inflammation, and reduce future flare-ups. Improvement may take several weeks or months.
Medications may also help manage symptoms. Dapsone is commonly used to relieve itching and rash symptoms more quickly. Because this medicine can cause side effects, regular blood tests are usually needed during treatment.
Some people may also benefit from avoiding other triggers that worsen symptoms.
