Dermatitis herpetiformis is a skin rash that occurs in some people with celiac disease; however, only about 20 percent of people with this skin condition have intestinal symptoms of celiac disease. Medications are available to treat it, but a gluten-free diet should still be followed as part of a person's treatment plan.
Dermatitis herpetiformis (DH) is a severe, itchy, blistering manifestation of celiac disease. The rash usually occurs on the elbows, knees, and buttocks. Not all people with celiac disease develop this condition. Unlike other forms of celiac disease, the range of intestinal abnormalities in dermatitis herpetiformis is highly variable, from minimal to severe. Only about 20 percent of people with DH have intestinal symptoms of celiac disease.
To diagnose dermatitis herpetiformis, the doctor will test the person's blood for autoantibodies related to celiac disease and will take a biopsy of the person's skin. If the antibody tests are positive and the skin biopsy has the typical findings of dermatitis herpetiformis, people do not need to have an intestinal biopsy.
Both the skin disease and the intestinal disease respond to a gluten-free diet and recur (come back) if gluten is added back into the diet. In addition, the rash symptoms can be controlled with medications such as dapsone. However, dapsone does not treat the intestinal condition; people with dermatitis herpetiformis should also maintain a gluten-free diet.