Dermatitis herpetiformis: Causes, treatment, and pictures

About 10 percent of people with celiac disease also develop dermatitis herpetiformis. There is no cure for the condition, but people can reduce the symptoms with medicines and lifestyle changes.

The National Organization for Rare Disorders (NORD) consider dermatitis herpetiformis, or DH, a rare disease. It appears to affect people aged 30–40 years and rarely affects children. Men are at a slightly higher risk than women.

This article will discuss the symptoms, causes, and treatment of DH, and how it relates to celiac disease.

Symptoms

The symptoms of DH vary for different people, so not everyone may experience all symptoms. Typically, it affects three areas of the body — the skin, the gastrointestinal (GI) tract, and the mouth.

The skin

The most common effects of DH appear on the skin, with symptoms such as itchy blisters and raised clusters of lesions.

A strict gluten-free diet is the most effective treatment option for people with DH. A registered dietician can help identify and eliminate both obvious and hidden sources of dietary gluten and recommend alternatives for the short- and long-term.

Doctors often prescribe a medicine called dapsone to provide immediate relief from symptoms.

Some people, however, cannot tolerate dapsone treatment. These individuals can instead take other forms of medication that contain substances called sulfapyridine or sulfamethoxypyridazine.

People may continue to take this medication for anywhere between a few months to 2 years. After this, DH can go into remission. Remission is when a person has no symptoms for more than 2 years while not using medication or a special diet.

DH and similar conditions

People may mistake DH for other conditions with similar symptoms, including:

• Eczema: Also known as atopic dermatitis, eczema is a group of skin conditions that cause skin inflammation or irritation. Common symptoms include dry skin, rashes, and itching, especially on the arms and behind the knees.
• Scabies: Scabies is a skin condition caused by a mite infestation. It is highly contagious and spreads by direct skin contact.
• Linear IgA disease: This disease is a rare and often long-term skin problem the characteristics of which are groups of itchy blisters and raised lesions on the skin. It is an autoimmune disease that certain medications can trigger.

Outlook

DH is a long-term, chronic condition and tends to persist lifelong in most people.

People can control their symptoms with a combination of dapsone treatment and a gluten-free diet. After several years, the condition can go into remission.

People with DH can manage their condition by ensuring regular medical checkups and guidance from a specialist skin doctor, called a dermatologist, and a nutritionist.

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