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Dermatitis Herpetiformis (DH)

June 19, 2012

Dermatitis Herpetiformis (DH)

June 19, 2012

Question:

I’m over 60 and newly gluten sensitive. I suspect I have DH; skin itches, especially ears/face/shins, arms; also acid reflux. I am eating gluten free. Other suggestions?

Answer:

Dear Joseph,

You don’t mention if you have see a physician for testing for dermatitis herpetiformis (DH), but if you have not, that is the first thing you should do. It is very important that you not self-treat DH without a diagnosis, because, per celiac expert, Dr. Peter Green, “if you have a positive diagnosis of dermatitis herpetiformis, you have celiac disease. And you must adhere to a gluten-free diet no matter how “normal” your intestine may appear.”

Diagnosis of DH is done through a skin biopsy and should be done by a knowledgeable dermatologist. Although DH biopsies are often positive for a long time after gluten has been taken out of the diet, it’s best to be eating gluten before being tested to get the most accurate diagnosis, so I recommend you add gluten back in to your diet before seeing a dermatologist for testing.

If testing for DH is positive, you will need to follow a 100% gluten-free diet for life for long term control, but in addition, you will initially need medications prescribed by your physician to help alleviate the itching and burning of the skin blisters, as it typically takes at least a couple of weeks for the effects of a gluten-free diet to kick in.

In regards to your acid reflux, it is possible that it will clear up as well on a gluten-free diet, although, again, testing is the most important 1st step for you. I hope you find answers and relief from your itching skin soon!

In good health,

EA Stewart, MBA, RD

References:

Green, P. Celiac Disease. A Hidden Epidemic. New York: Harper Collins Publishers; 2006


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