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What is Dermatitis Herpetiformis?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 28 March 2018
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Dermatitis herpetiformis is a chronic skin condition which appears to be linked with gluten consumption. The condition appears most commonly in people with gluten sensitivities, such as individuals with Celiac Disease, although it can also appear in patients for whom gluten sensitivity is not believed to be a problem. Although the “herpetiformis” would seem to suggest that the herpes virus is involved in this skin condition, this is not actually the case. The name is a reference to the appearance of the condition, not the cause.

Individuals with dermatitis herpetiformis experience an intense itching and burning sensation and a rash, followed several days later by the appearance of small fluid-filled papules. The papules usually cluster together, and they tend to be whitish to pink, with the surrounding skin being flushed red. Once the papules appear, the skin turns intensely itchy, and many people burst the papules by scratching. Over time, the outbreak will fade away on its own, usually taking around two weeks to resolve.

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Dermatitis herpetiformis can appear anywhere on the body, including the legs, arms, and neck. Once one outbreak has been experienced, it is likely to appear again. The condition can be extremely unpleasant, thanks to the mixed intense burning and itching sensations, and it can also be aesthetically unpleasant, as the papules on the skin are not enjoyable to look at. It is also viewed as a key indicator of gluten sensitivity, and in patients who experience dermatitis herpetiformis for the first time with no previous known sensitivity to gluten, it can be a red flag.

Researchers theorize that the skin condition happens when gluten in the intestinal tract binds to certain antibodies, and then starts circulating in the bloodstream. When the gluten reaches the surface of the skin, an immune reaction occurs, causing the burning, itching, and eventual emergence of a papule on the skin. This makes dermatitis herpetiformis a type of autoimmune disease, since it is caused by the body's attack on itself.

A drug called Dapsone can be used to control dermatitis herpetiformis outbreaks. Some patients also find that soothing baths and other measures can ease the uncomfortable sensations associated with this dermatological condition. Future outbreaks can be avoided by refraining from gluten consumption, which can require being very careful about any foods consumed, because gluten can hide in some very surprising places. Patients may want to know that not everyone with gluten sensitivities develops dermatitis herpetiformis.

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