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Does Dh Have To Blister?
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Is blistering a necessary characteristic in order for it to be considered DH?....before a biopsy either confirms it or not that is. Mine has never blistered.

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Ads by Google:

http://www.cureceliacdisease.org/archives/faq/can-a-skin-rash-be-associated-with-celiac-disease

"Can a skin rash be associated with celiac disease?

Dermatitis herpetiformis (DH) is an itchy, blistering skin condition that is a form of celiac disease. The rash usually occurs on the elbows, knees and/or buttocks, and is characterized by its bilateral nature; both knees (and/or both arms) are affected, seldom just one. Many people with DH have no digestive symptoms and only about 40% of them have the positive blood tests (serology) for celiac disease. However, they almost always have the same, gluten-dependent intestinal damage as those with more common symptoms of celiac disease.

DH is diagnosed by a skin biopsy, which involves removing a tiny piece of skin near the rash and testing it for the IgA antibody. DH is treated with a gluten-free diet and medication to control the rash, such as Dapsone or Sulfapyridine. Drug treatment is short term, usually until the gluten-free diet begins to relieve symptoms. It’s not necessary to perform an intestinal biopsy to establish the diagnosis of celiac disease in a patient with DH; the skin biopsy is definitive."

Some pictures from a reliable source:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002451/

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Hi Jenn, my DH comes in many different forms all at once. Some of them are not blisters at all but still definitely DH, so I would say the answer is no.

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No, it does not have to blister. Read the entire thread in this link:

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Thank you guys for the input, it's really helpful.

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I think that, according to the experts, DH does blister. I posted a couple of medical references about this. It could be possible that after you have been gluten-free, it doesn't come back as strong when glutened.

Here's a few more:

http://celiacdisease.about.com/od/whatisceliacdisease/a/DermatitisHerp.htm

http://www.dermatitisherpetiformis.org.uk/

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DH presents as blisters on me.

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I saw a new Dermatologist today. This is the 5th one that has looked at my skin to determine what the rash is or is not. He asked if I had blisters (yes) and said he really wished he had seen a blister. I had pictures and described how I used a sterile needle to release the fluid from blisters. That seem to satisfy him that I had blisters even though I have quite an area of rash that the skin has broken and inflamed. Gave me another steroid cream and warned me about infection, told me not to scratch. He asked me, "Does it feel like nettles?" "You ever gotten into a nettle patch?" My reply is "Yes sir."

He wasn't really happy that I was on Dapsone but did take 2 more biopsies NEXT to the lesions on my lower back. He asked if I had had a G6PD test to see if I could tolerate Dapsone. Not had that so he ordered that test. So, not sure without seeing a blister and with being on Dapsone what this biopsy will show but he documented on my record that I had DH.

I told him about the Dermatologist that told me to see a mental/health doctor. He defended him by saying that the skin on my back is thickened from rubbing, scratching and the lesions healing and that is why he would have told me it was neurological in nature. I guess he had to speak up for his associate. :rolleyes:

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    • I figured I would update those who were wondering.  I have gotten the appt. so far moved up to August 30. I am waiting to have gene testing done via swab for all 3 of my kiddos tomorrow. My daughters celiac antibodies came up negative but her IgA is low which the ped said could cause false negative antibodies for celiac so she will need to see a GI dr. also. The pediatrician is going to call the GI to try to get them in sooner. I am keeping them all on a gluten diet until the GI dr. decides what to do. I am on the cancellation list already for my son, however I am not going to be persistent with my phone calls to them until I have the results of the gene test. I really want that result in my hand before going to the GI dr if I can. Maybe if he is positive, along with his bloodwork and my history they can forgo the endoscopy. But he will eat gluten till then.  My husband and I have been very honest and upfront with him as to what is going on and the possibility of the endoscopy and what that entails and although scared in general he seems ok after assuring him that since I have it he has me to help him every step of the way.  Going through his current diet with him I realized that he is truly on such a low gluten diet that I am actually surprised his bloodwork shows antibodies at all!  So I told him to make a list of allllll the gluten he could possibly think of eating and he needs to pound it until the GI visit or endoscopy. Funny thing is everything he keeps thinking of to want to eat...is already gluten free!  The other night we were at a friends and he asked if he could be done with his hotdog. I made him finish just the bread 😂 Thanks for your help and advise and I will keep y'all posted on both kids!  My oldest is a ok as far as all his antibodies. Just actually had a follow up for other immune issues and all his levels are now normal!
    • I like your plan Cara, I may have to include it in my sons.    Poor little guy is still very very sick. I think he is resisting and cheating, despite having the support of two other siblings and a 100% gluten-free home. 
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    • Well, you can probably get an apple or something.  You might be able to get someone to boil you some eggs.  But be careful of things like nuts that should be naturally gluten free.  They have almost always been soaked in a flavor solution that usually containes caramel coloring, "soy" (wheat) sauce and other aditives.  If I am really hungry and must eat in a Chinese restaurant, I order plain white rice and steamed vegetables.  But even so, you must monitor it carefully.  The rice sometimes has other substances added to give it a better texture, and very often the vegetables have in fact had "just a little bit" of soy sauce added.  To be fair, celiac disease is hardly ever found in East Asians, so understandably people are not tuned it to it.  Also, culturally, with the exception of fruits, it is generally thought that the flavor of foods needs to be enhanced, so it is had to find anything natural even in the "western" gorceries. Even in the western restaurants, be careful.  Fish and meat and often vegetables are usually pre-marinated. I will not even attempt to address the issue of cross-comtamination, since that is a whole higher order of things. I do know what I am talking about; I have celiac and have worked here for nearly 7 years.  
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