Also referred to as gluten rash or Duhring’s disease, dermatitis herpetiformis is a discomforting skin condition marked by inflammation of the skin and formation of blistering, burning, and itchy skin rashes. The rashes can occur all over the body, but are more commonly seen on the scalp, elbows, back, buttocks, and knees. Dermatitis herpetiformis can also be a symptom of some other more serious health condition like celiac disease or gluten allergy.
Medications and intake of a gluten-free diet can help treat dermatitis herpetiformis and prevent future cases.
Dermatitis herpetiformis is thought to be one of the most extreme forms of itchy skin rashes. Listed below are some of the common signs and symptoms of this skin disorder:
- Before the onset of severe dermatitis herpetiformis skin rashes, the affected skin region will experience itchiness and burning sensations.
- The affected skin area will eventually exhibit a full-blown outbreak, characterized by many groups of clear blisters, flat lesions, and small bumps known as papules. The papules are full of transparent fluids; it is very easy to scratch them off.
- The pimple-like lesions normally cause a lot of itchiness. They may also elicit burning or stinging sensations. All the above symptoms may be mild or severe in nature.
- With the passage of time, the skin rashes crust over and cease to be itchy. A purplish scar is all that remains; it may persist for some weeks.
- As the older skin lesions heal, new skin rashes develop in their place. This process may continue for many months and even years, characterized by regular episodes of flare-ups and remissions.
- A few individuals with dermatitis herpetiformis may also suffer from celiac disease-linked symptoms such as fatigue and lethargy, weakness, and pain in abdomen.
- The rashes tend to be of the same shape and size. They may affect the right or left side of the body. People with older cases of dermatitis herpetiformis tend to suffer from newer bouts of the skin lesions at the same spots as previous cases, almost all the time.
- The rashes occur symmetrically almost throughout the body. Dermatitis herpetiformis is however more widespread in body areas such as the scalp, back of the neck, shoulders, elbows, lower back, buttocks, and the knees.
Causes of dermatitis herpetiformis
- Dermatitis herpetiformis typically occurs due to the underlying presence of a condition called celiac disease, w8hich in turn is marked by allergy or intolerance to gluten. Celiac disease is usually a hereditary condition, while gluten in a kind of protein that occurs in different types of food grains like wheat, barley, rye, and oats, etc.
- It may be noted that even though dermatitis herpetiformis has the word ‘herpe’ in it, the skin disorder has no association with any kind of herpes virus infection.
- The skin rashes and intestinal problems experienced by dermatitis herpetiformis patients occur as part of an allergic reaction to gluten proteins, caused by the IgA antibody. These antibodies normally occur in the eyes, oral cavity, and the intestinal walls.
- The immune system produces antibodies to protect the body from infections as well as attacks by varied microorganisms and toxins. Occasionally, as in the case of people with celiac disease, the immune system erroneously identifies foods like wheat, barley, etc., as harmful for the body and produces antibodies to fight them off. On similar lines, the body may also produce antibodies for fighting normal environmental elements like dust, pollen, etc. People with such antibodies are said to be allergic.
- In celiac disease patients, the IgA antibody attack gluten proteins and damage the intestinal villi, subsequently leading to deficient absorption of vitamins, minerals, and other nutrients by the body.
- The IgA antibody attaches itself to gluten proteins and migrates into the bloodstream. It then clogs the tiny blood vessels, especially the ones occurring in the skin. The WBCs rush to such spots and produce a chemical called ‘complement’ to eliminate the blockage in the blood vessels. The resultant reaction is what causes the formation of itchy dermatitis herpetiformis skin rashes.
- Women may be prone to celiac disease, but men are at higher risk to developing dermatitis herpetiformis skin rashes.
- Dermatitis herpetiformis normally occurs in the twenties, but it can also affect children. It is a lifelong condition, but patients may experience remission even when they consume gluten-abundant foods.
- Doctors generally prescribe dapsone antibiotic to treat dermatitis herpetiformis. However, as the drug has severe side effects, the health care provider will gradually increase the dosage till it fully becomes effective.
- Doctors may also prescribe sulfapyridine, tetracycline, and certain immune system inhibiting drugs. They are however not as effective as the antibiotic.
- The best way to clear out dermatitis herpetiformis skin rashes is by opting for a gluten-free diet. Such a diet however comes with deficient nutrients for the body. Hence, patients need to consult a nutritionist so as to be able to compensate for the loss of nutrients.