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Dh Or Psoriasis?
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9 posts in this topic

I've read everywhere that DH is extremely itchy, but mine is only itchy when it first appears. It usually starts off as a small blister (which is itchy) but once the blister goes, it's not itchy at all. My mum thinks it's psoriasis but I'm not sure. I don't seem to get it really bad either, just small patches.

This was in July 2012:

http://i49.tinypic.com/34pdl5t.jpg

http://i48.tinypic.com/21dphm8.jpg

This how it usually starts, just a tiny blister type spot:

http://i47.tinypic.com/d4s8.jpg

This is from today:

http://i50.tinypic.com/27zdgqo.jpg

I've also got it on my face at the moment, but didn't really want to take a picture. I only seem to get it on my left hand/arm, legs and face but recently had a patch on my tail bone.

Any information/advice would be greatly appreciated. :)

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Looks a lot like dh to me. I don't believe psoriasis blisters. Does yours burn or sting? Tail bone is a classic place for dh to present. You might be lucky so far in that it doesn't drive you nuts itching ---- yet. How long do the lesions usually last before they heal?

Oh, gee, I see now you are dx'd celiac ---- in that case you have dh. You've been gluten-free since 2011 ---- that explains why it doesn't drive you bonkers itching. You are getting cc'd somewhere & that's why the dh is showing up. Go over everything --- everything & try to figure out where the cc is coming from. DH is very, very sensitive to the smallest amount of gluten.

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Hmm, looks somewhat like DH but if you think you've been pretty strict about your diet, it also could be something else. My psoriasis started after I went gluten-free. I also get little blisters like that on my hands (and nowhere else) occasionally but It is NOT DH. Anyway, a decent dermatologist should be able to tell pretty easily.

richard

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I have palmoplantar pustular psoriasis. It only shows up on the palms of my hands and around the heels and bottoms of my feet. There is also a generalized pustular psoriasis that can show up on any part of the body. In both cases, the pustules look like whithead pimples. After a day or three they turn into little red spots. As they heal, the skin will crack and peel.

If your pustules don't look like whitehead pimples, that's not what you have.

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Looks a lot like dh to me. I don't believe psoriasis blisters. Does yours burn or sting? Tail bone is a classic place for dh to present. You might be lucky so far in that it doesn't drive you nuts itching ---- yet. How long do the lesions usually last before they heal?

Oh, gee, I see now you are dx'd celiac ---- in that case you have dh. You've been gluten-free since 2011 ---- that explains why it doesn't drive you bonkers itching. You are getting cc'd somewhere & that's why the dh is showing up. Go over everything --- everything & try to figure out where the cc is coming from. DH is very, very sensitive to the smallest amount of gluten.

It burns as the blister appears but as soon as the blister goes and the "rash" appears, it seems to be fine. The patch on tail bone, however, is extremely itchy - especially at night. They take a long time to heal (4-6 weeks) but I generally take ages to heal anyway.

I had some BBQ Rib Doritos at the weekend and I think that's where the CC came from - there's no gluten containing ingredients but they're made in a factory that handles gluten. I know I shouldn't have eaten them, but I guess I'll learn from my mistakes!

Hmm, looks somewhat like DH but if you think you've been pretty strict about your diet, it also could be something else. My psoriasis started after I went gluten-free. I also get little blisters like that on my hands (and nowhere else) occasionally but It is NOT DH. Anyway, a decent dermatologist should be able to tell pretty easily.

richard

As I said to the above poster, I'm pretty sure it was the BBQ Rib Doritos that I was CC'd with. My mum and a bunch of my cousins have psoriasis so that's why I assumed it was that, but with the Coeliac I thought I'd get a few opinions. I guess if it gets worse, I'll see a dermatologist. Thanks!

I have palmoplantar pustular psoriasis. It only shows up on the palms of my hands and around the heels and bottoms of my feet. There is also a generalized pustular psoriasis that can show up on any part of the body. In both cases, the pustules look like whithead pimples. After a day or three they turn into little red spots. As they heal, the skin will crack and peel.

If your pustules don't look like whitehead pimples, that's not what you have.

I looked up palmoplantar pustular psoriasis and it doesn't look like that at all. Looks very painful though, I feel for you!

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I looked up palmoplantar pustular psoriasis and it doesn't look like that at all. Looks very painful though, I feel for you!

Thanks. It is very painful, but the good news is that as long as I stay away from gluten, soy, most forms of corn, and foods high in salicylates, it goes away completely. :)

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Thanks. It is very painful, but the good news is that as long as I stay away from gluten, soy, most forms of corn, and foods high in salicylates, it goes away completely. :)

I'm glad you're able to prevent it. :)

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I have had spots like those too. My blisters are long gone, but my skin still itches like crazy. I wish my skin did not itch so much. My skin now peels and is very dry. I have been mis-diagnosed with Psoriasis several times. A skin biopsy in one spot done last year did show a small amount of Psoriasis once. But my next dermatologist said it was definitely not Psoriasis. I have several friends with Psoriasis, and none of my skin areas look like theirs do. I am puzzled as to what is really going on. I am thinking it is just a form of Gluten Intolerance.

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Psoriasis takes many different forms. Pustular, guttate, etc., etc. I suppose it is theoretcally possible to have both psoriasis and DH, although usually one seems to have one or the other. Have you looked at pictures of all the different forms of psoriasis and of DH? Generally, looking at these pictures, you can find something that matches what yours looks like. Psoriasis does not tend to scar; DH does tend to scar although there are variations that do not leave scarring. Psoriasis itches like cracy but generally does not hurt; DH generally does both. Do some googling and see what you can come up with is my best advice.

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    • Squirmingitch, I forgot to mention best of luck to you during the storm! I hope you are safe and that your home isn't impacted too badly! I'm on the coast in SC so we will see some storms from it but nothing near as bad as what you will have. Take care and good luck.
    • SquirmingItch, I really appreciate you gathering info for me! To answer your questions, yes, I'm on Dapsone now and have been on it for about 4.5 weeks. I have been gluten free for the same amount of time. I started on 50 mg of Dapsone which didn't seem to help much. I spoke to my doctor about it and after about a week she raised it to 100 mg. Since then I did notice a huge improvement in both my rash and itch. I no longer have any active rashes and my itching isn't completely gone but it's very minimal. I have been getting weekly blood tests done and will soon be moving to monthly.  My DH skin biopsy was done before the gluten free diet and Dapsone. My results for the skin biopsy came back as inconclusive, but even with those results, my doctor was convinced I had DH. I specifically asked her about the fact that she took the biopsy directly from the lesion rather than next to it and if that affects the result. Her explanation was that if it's a fresh enough lesion that isn't scratched, there should be IgA antibodies present. But she said that an inconclusive result isn't surprising because the IgA antibodies come and go from the skin so quickly that it can be very difficult to get a positive result, even in someone who is positive.  That's when she decided to run the celiac blood panel on me. And even though those results came back positive for the deamidated gliadin and negative for tTg, she still is very convinced that I have DH. I am happy that my doctor seems to be certain, but I would just feel better if the results were more definitive. The one other thing I am waiting on is I have been asked to attend grand rounds at the local academic hospital in 2 weeks. I guess grand rounds is where all of the academic dermatologists and dermatopathologists get together to review certain complicated cases. They will meet with me, review all of my pictures, biopsies and blood tests. My situation has been so complicated so they asked me to come. I am hoping maybe then I will get some more answers. 
    • It sure is, it really is. 
    • shellyb, I have info. for you & you may yet be able to get an official dx from your dermatologist as she sounds like she would be willing to learn. If you are dx'd with dh it is definitive & no other testing is needed. You don't need to see a GI. Im in FL & have had a long day watching Tropical Storm Hermine & making preparations for it's track which is over where I live. I'm tired! I will have links for you to reputable medical info. on the rash but it make take me till tomorrow or even longer if we lose power.  I'll be back as soon as I can. Question: You're on Dapsone now? How long have you been on it? How is it working for you? Are you getting the proper testing at regular intervals to make sure it isn't doing bad things to you? Were you gluten free before the skin biopsy?
    • Thank you so much for your quick response, GFinDC. While I wouldn't be completely opposed to another skin biopsy, I already had 4 done (3 were done prior to my dermatologist suspecting DH) so I don't love the idea of  yet another hole and scar on my body. Plus, fortunately I don't have any fresh lesions now, which I believe is needed for the biopsy. I wish I would have known to see a GI before going gluten free but I was so desperate to get any relief that I started that and Dapsone as soon as my doctor mentioned it to me.  My rash is definitely symmetrical and I have it in all of the "classic" DH spots although it basically spread over my entire body. As much as I'd like a more formal diagnosis, I really don't think I can go through all of that again. It was so bad that not only was I getting no sleep but I had to change my sheets every morning because there was blood all over them. Sorry, TMI. The worst part is that this all developed during my ninth month of pregnancy and got much worse after I delivered my baby. So not only was I dealing with this insanely itchy rash but I had a newborn and a toddler to take care of.  My daughters' pediatrician did mention doing DNA testing on me first and then my daughters to see if there's any concern that they may be susceptible. I may just go that route for now. I was just curious if others have had similar test results to mine and how did their doctors treat it? Thanks again!
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