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For Testing, What Is An "active Lesion?"

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Hi, Gang!

About two weeks ago, our daughter showed me a spot on the back of her knee that she said itched really bad. I told her it looked like one of the spots I get on my hands, forearms, and occasionally on my legs and tops of feet. She put a bandaid over it so that she couldn't scratch it and it wouldn't rub on her jeans during school. A few days later, the whole back of her knee was a bright red mess! It looked to me as if it was irritated from the bandaids, but she said it itched. I told her to leave the bandaids off, put shorts on at home, and to put antibiotic cream on the area. It looked somewhat better the next day, but the day after that she showed me other spots that had sprung up down her leg! One on the front side of her knee was like a water blister and she broke it open. Now they all look like open sores and a few of them are the size of nickel or a bit larger. She also has a few spots on her other leg as well.

I took her to our PCP (had to see the PA) on Thursday, and he said it looks like impetigo. He suggested cream and an oral antibiotic. I re-emphasized our family connection to celiac disease (our oldest son, my father with definite dx; my sister, brother, and me with probably celiac disease but no dx) and insisted that I would like to have an updated celiac disease panel run on her as well as a skin biopsy for DH. He was not thrilled, to say the least. He wanted to give it a week of treatment and if it cleared up, all would be good. If not, then we could test for DH. I told him I didn't want to wait a week. They couldn't do the biopsy that day because of scheduling, so we set it up for Tuesday.

My question is: the spots are looking much better, so will the antibiotic treatment cause her to test negative? I read on one post that a steroid treatment would mean a negative result. The spots will definitely still be visible on Tuesday, but does that mean they're "active?" They are no longer draining, but still itch when she touches them. Should I have her discontinue the antibiotic cream and oral?

I am having her eat as much gluten-containing food as possible this weekend. I just don't want this to be a missed opportunity to find the culprit. I know most people go for YEARS without getting the correct dx, just like my dad. Words of wisdom??


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Visible does not mean active, I'm afraid. If they are not driving her crazy they are probably not active :rolleyes: If you want a positive result you should discontinue the AB's, and yes, eat gluten and try to stir things up a bit. You do know it is important that the testing is done on the skin immediately adjacent to a lesion, right? and not on the lesion itself.


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Visible does not mean active, I'm afraid. If they are not driving her crazy they are probably not active :rolleyes: If you want a positive result you should discontinue the AB's, and yes, eat gluten and try to stir things up a bit. You do know it is important that the testing is done on the skin immediately adjacent to a lesion, right? and not on the lesion itself.

Thank you, Mushroom! Yes, I do know about the testing site and mentioned it to the PA. He reacted as if he was already aware. If her skin continues to clear and she has no further spots crop up, I may cancel the appointment and wait for another outbreak. No need to make her go through the procedure twice....and I wonder if they would even do another biopsy if the first one comes out negative?? Stopping the antibiotics today!

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    • Hi Gemini, My birthday is in June, so I'm a Gemini too---and I do agree with some of your good points.  I had written that one could EITHER try Dr. Fine's stool sample testing, where his EnteroLab looks for elevated numbers of IgA antibodies to various food proteins (gluten, milk proteins, soy proteins, yeast proteins, etc.), OR one could just avoid eating or drinking or touching suspect food proteins, for at least a month (3 months is better), and see whether AVOIDING eating and touching such proteins causes improvement or not, in one's symptoms and lab test results. I urge you (and anyone else who wonders about this) to speak by phone, with people working at Dr. Fine's EnteroLab,  and state your objections to them, and see what their replies might be. Here's their phone number: 972-686-6869. I called Dr. Fine's Enterolab, and the folks I spoke with there, were nice enough to reply to any questions that I had, including one lady (I believe she was a nurse) there telling me about the "IgA deficiency" blood test called "total secretory IgA", which one can do first, to see whether it pays to try EnteroLab's stool sample testing! From what I understand, Dr. Fine doesn't try to distinguish between Celiac and non-Celiac forms of gluten "sensitivity". This is because although Celiac Disease is VERY serious, it is the "tip of the gluten-sensitive iceberg", meaning, that higher percentages of gluten-sensitive folks are NON-Celiac gluten-sensitive folks, who can also have major health problems, but the non-Celiac folks have "villi" that are sub-microscopically damaged, and thus, this sub-microscopic villi damage cannot be seen under the microscope--but it's there! And, Dr. Fine's point, is that in both Celiac and non-Celiac types of gluten sensitivity, the cure is the same: AVOID GLUTEN! Dr. Fine doesn't use the term "gluten intolerance", because newer uses of the word "intolerance" refers to NON-PROTEIN intolerances, such as "lactose/milk sugar intolerance" (lactose/milk sugar is a carbohydrate, not a protein), and intolerances are not related to one's immune system, while gluten "sensitivity" and other "sensitivities" ARE related to one's immune system, with ingestion (eating or drinking the offending proteins) causing one's immune system to cause the production of antibodies to those proteins that one is "sensitive" to. Many years ago, a friend of my husband, went to a local doc who told my husband's friend to try avoiding gluten. My husband's friend, without being biopsied, went off gluten, and has become well, ever since that day long ago. Some years ago, both my husband and I did Dr. Fine's "EnteroLab" stool sample testing, for gluten sensitivity. My husband came out positive, and I came out negative. My husband has avoided gluten, ever since then, and I try to do so also, to avoid tempting him to cheat, and he has avoided getting colds, etc., the way he used to, before he stopped eating glutenous foods. And, there is much disagreement (I know, because I'm a retired nurse, and I've been a patient now and then) between doctors, about gluten sensitivity, and about anything medical. So, I've learned to be wary of the terms "valid medical institutions" and "valid medical professionals". What may seem valid today, might be disproved tomorrow, and what might not seem valid today, may be shown to be valid tomorrow. Medicine is always in flux, thankfully. If not, medicine would be "dogma". If you call and speak with Dr. Kenneth Fine (M.D., gastroenterologist, "sensitive" to many food proteins himself, including gluten, but not "Celiac") &/or to the folks working at his Enterolab, please let us know what their replies are, to your objections to his lab's work. In the meantime, let's both try to keep an open mind. Sincerely, Carol Sidofsky (wife of gluten-sensitive non-Celiac hubby, and I'm a retired RN/nurse)
    • Where do you live? I was going to go to Cleveland but just got an appointment with Celiac Center in Boston. 5 hour drive next month. Hoping it is worth the trip. Might be worth looking into.   I just educated a lab on DGP yesterday. They just brought a celiac panel in house and i saw they were using gliadin. I think they are running my sample on the old test in-house and sending it out for DGP to see what happens.     
    • Me too, I am not a member of Medscape.    Is this the article?  I goggled the topic and filtered using "news".  (Hope it works!) Celiac Disease in Children: Experts Clarify Diagnosis and Management Recommendations   Here is what I liked.....a gluten sniffing dog for helping kids to remain dietary compliant!   Count me in!  
    • There is not test for non celiac gluten sensitivity. That would not cause your numbers to be elevated.
    • Sorry it's not working . If you google the article in the first post you should be able to bring it up.  It's from 3 of the leading Celiac Meds Docs so really worth a look.  
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