37 replies to this topic

[JaneWhoLovesRain]

Seems somewhere in all my reading I saw that there are a couple of other rare causes of DH that are not gluten related. 95% + of the time it is DH but on occassion it is something else. I've tried to find the original article or more on this but can't. Anyone know if in fact something else can cause DH?

Jane

[a1956chill]

Seems somewhere in all my reading I saw that there are a couple of other rare causes of DH that are not gluten related. 95% + of the time it is DH but on occassion it is something else. I've tried to find the original article or more on this but can't. Anyone know if in fact something else can cause DH?

Jane

I was " officially" diagnosed because of a positive DH biopsy and my response to a gluten free diet .

My understanding from my GI doc and my Dermatologist is that DH = celiac.

[pricklypear1971]

Other things can trigger an outbreak - salicylates, iodone, I've seen bromines mentioned...but the underlying cause is gluten. I have seen mention of other skin diseases with similar etiologies mentioned.

Are you looking for differentials or an alternative cause for the diease?

[a1956chill]

Other things can trigger an outbreak - salicylates, iodone, I've seen bromines mentioned...but the underlying cause is gluten.

I agree with this.
I have been gluten free for a long time and if I consume large amount of iodine I will have a breakout. The iodine seems to "aggravate" or "activate" the antibodys in my skin .
And any and I do mean ANY CC ( gluten cross contamination )will trigger a break out.

[Lisa]

DH = celiac.

But Celiac Disease does not = DH.

It's my understanding the DH is a gluten intolerance which manifest itself on the skin. You can have both Celiac and DH and the RX is the same.

[IrishHeart]

Yes, DH is the skin manifestation of Celiac Disease.

And yes, it's true that not everyone with Celiac has DH, but everyone with DH has Celiac.


From the Univ. of Maryland Center for Celiac Research

"Is it necessary to have an intestinal biopsy to confirm the diagnosis of Dermatitis Herpetiformis (DH)?"

A skin biopsy is sufficient to confirm the diagnosis of DH.

DH is the skin manifestation of celiac disease.

[Lisa]

DH is the skin manifestation of celiac disease. [/b]

In ALL cases? That's what the Jane was inquiring about.


This is what I have found:

Sprue (gluten enteropathy)
Wheat/Gluten/Gliadin intolerance
Idiopathic
Thyroid disorders

BTW - I love the name JaneWhoLovesRain.

[IrishHeart]

In ALL cases? That's what the Jane was inquiring about.


This is what I have found:

Sprue (gluten enteropathy)
Wheat/Gluten/Gliadin intolerance
Idiopathic
Thyroid disorders

BTW - I love the name JaneWhoLovesRain.

I love that name, too!

That's what I read: A diagnosis of DH is a DX of Celiac.

It does not exclude a thyroid disorder as well, but DH IS Celiac.

I'll keep looking....

[IrishHeart]

Source:

Dermatitis Herpetiformis: Skin Manifestation of Celiac Disease. National Digestive Diseases Information Clearinghouse. Accessed: Sept. 5, 2010. http://digestive.nid...seases/pubs/dh/


Question: If I have dermatitis herpetiformis, do I also have celiac disease? I've been diagnosed with the skin rash dermatitis herpetiformis. Does this mean I also have celiac disease and must follow a gluten-free diet?

Answer:
In a word, yes - if you have a diagnosis for dermatitis herpetiformis and your celiac antibody blood tests also came back positive, you have celiac disease. If, however, your blood tests for celiac disease came back negative, your dermatologist may refer you to a gastroenterologist for an intestinal biopsy, considered the gold standard for celiac disease diagnosis.

About 90% of dermatitis herpetiformis patients have a positive intestinal biopsy.

In celiac disease, your body mistakenly attacks the villi in your small intestines. Dermatitis herpetiformis represents another autoimmune reaction from gluten - instead of attacking your intestinal villi, your body's immune system mistakenly attacks your skin. This attack produces an intensely itchy rash with water blisters and itchy red bumps which occurs most frequently on the elbows, knees, buttocks, lower back and the back of the head.

Dermatitis herpetiformis affects between 15 and 25 percent of people with celiac disease, mainly adults, and many of people these have no gastrointestinal symptoms. Although the medication dapsone can help to clear up your rash, you'll need to stay on the gluten free diet long-term to prevent celiac disease complications.

[IrishHeart]

Jane, did you ever call the GI doctor I recommended? He is the best guy in this area!

[pricklypear1971]

It is not uncommon for gluten sensitive/Celiacs to have a variety of skin issues. Not all are DH.

There are other autoimmune diseases linked to skin issues.

There are other diseases linked to DH, but those alone don't cause DH. The Celiac component causes DH.

Thyroid/Hashimotos seems to be the most frequently linked to DH (other than Celiac). Which, if you back into it makes sense since there's a thought that Hashis is caused by gluten/Celiac.

There's also the whole world of people who are pretty sure they have a gluten related rash that don't have a + DH biopsy for various reasons. No biopsy, bad biopsy, etc. so quite frankly I'd bet the rate of DH is much higher than actually reported or DH is just one type of gluten rash.

[IrishHeart]

It is not uncommon for gluten sensitive/Celiacs to have a variety of skin issues. Not all are DH.

.... so quite frankly I'd bet the rate of DH is much higher than actually reported or DH is just one type of gluten rash.

Yes, I agree totally.... and my GI doctor told me flat out....even if your oozey scalp scabs are not "classic DH", it is still related to Celiac. They are all gone, but only reappear if I am glutened. I also have severely burning skin--from head to toe. (4 years now--ugh!)

I also read that DH is much more common in men. The only way my cousin's wife even figured out her elderly Dad had celiac was because the poor guy suffered from this "rash" his entire life! When her sister was DXED, she learned DH is a symptom and put it together.

It is also true that the majority of people with DH have minimal or no GI symptoms, they just think they have a rash, and therefore, probably never go to a GI doc. So many more UnDXed celiacs out there!

In that case, only a pretty smart dermatologist would know the DH-celiac connection.

A good celiac-savvy GI doc will (should?) know DH when she/he sees it.

[pricklypear1971]

Yes, I agree totally.... and my GI doctor told me flat out....even if your oozey scalp scabs are not "classic DH", it is still related to Celiac. They are all gone, but only reappear if I am glutened.

I also read that DH is much more common in men. The only way my cousin's wife even figured out her elderly Dad had celiac was because the poor guy suffered from this "rash" his entire life! When her sister was DXED, she learned DH is a symptom and put it together.

It is also true that the majority of people with DH have minimal or no GI symptoms, they just think they have a rash, and therefore, probably never go to a GI doc. So many more UnDXed celiacs out there!

In that case, only a pretty smart dermatologist would know the DH-celiac connection.

A good celiac-savvy GI doc will know DH when she/he sees it.

I think they will know DH they've id'd before. Should be the same but it isn't. I think my Derm suspected it but it was so disfigured from the immune suppressants he didn't pick it up visually - though he did ask about symptoms that in retrospect I know was feeling around for DH.

I think a savvy dx depends on putting together the ai connection (if there's one to be made- in my case there was) along with how the rash acts.

It's all about how it acts.

[Lisa]

As Jane inquired, you cannot say that all DH is attributed to Celiac Disease, exclusively, just as you can't say that all villious atrophy is attributed to Celiac Disease, exclusively.

DH is most commonly associated with Celiac, although some rare circumstances, it can be attributed to other sources. And I differ imho, that DH and Celiac are the same animal. Very closely aligned, yes.

I don't have the energy nor the time for debates. But, I wanted to clarify my point. Maybe we are just talking semantics. Continue on.....

[JaneWhoLovesRain]

In ALL cases? That's what the Jane was inquiring about.


This is what I have found:

Sprue (gluten enteropathy)
Wheat/Gluten/Gliadin intolerance
Idiopathic
Thyroid disorders

BTW - I love the name JaneWhoLovesRain.

Yup, that's what I mean - are ALL (100%) cases of DH because of gluten/celiac or is there something else that can cause it. I know other things, such as iodine, can aggravate it but I was wondering if there is something else that actually casuses it that has nothing to do with celiac or gluten.

I guess the reason I am asking is because I should be getting my biopsy results tomorrow and if in fact, I am told I have DH I want to know if that means a 100% certainty that I need to be 100% gluten free or if there is a possibility something else is causing it and further tests need to be done for that.

Oh, and thank you for loving my name. I love rainy days, crazy isn't it? Sunshine seems to aggravate my vertigo/off balance problems!