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Celiac Disease and Other Gut Diseases Often Present in the Skin

Celiac.com 12/29/2011 - About one in 100 people in America has celiac disease, while about one in four of those will develop dermatitis herpetiformis Duhring, which occurs when celiac disease manifests cutaneously, in the skin. Dermatitis herpetiformis Duhring is uncommon in children, with only 5% of cases appearing in children younger than 7 years. Most often, it presents in people over forty.

Photo: CC--MangeeMaking a proper clinical diagnosis of dermatitis herpetiformis Duhring, also known as Duhring’s disease, is challenging, and often requires the help of skin biopsy and direct immunofluorescence.

To do this, clinicians should look for antibodies against gliadin, endomysium, and transglutaminase, said Dr. Magdalene A. Dohil, of the University of California, San Diego, at a seminar sponsored by Skin Disease Education Foundation (SDEF).

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The fact that manifestations of celiac disease in the mucous and skin may point to Duhring's disease was one of the more important aspects of Dr. Dohil's discussion, for people with celiac disease, and those treating them.

Dr. Dohil noted that, at some point during the course of their disease, more than seven in ten people (74%) with celiac disease will have some type of skin manifestation. Most often, this skin manifestation occurs in the form of xerosis, which often triggers pruritus. Mucosal manifestations occur in 27% of patients, especially in patients with longer history of celiac disease.

Dr. Dohil pointed out numerous diseases, disorders, syndromes, and structural epithelial defects with clear connections between skin and gut. For example, 60%-82% people with asymptomatic inflammatory bowel disease present with mucocutaneous findings that include skin tags, fistulas, fissures, or abscesses in the perianal and genital areas. In 25%-30% of cases, these will precede GI complaints. Dr. Dohil said.

Overall, 6%-20% of all patients with inflammatory bowel disease develop oral lesions, but up to 80% of pediatric cases with Crohn’s disease and 41% with ulcerative colitis develop such lesions.

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Last December, I was horribly sick. Suddenly, questioning gluten; I didn't eat any. The change was beyond enormous, and I could not ever bring myself to voluntarily eat it, again. It was as if I was finally, not being electrocuted! A nasty, blistering rash went away, at the same time. Now, I am ...

Same here. Our doctor told us that my daughter does not have celiac right after the endoscopy. We were overjoyed. 2 weeks later, they called and gave us the test results, and that she does have celiac. I would wait at least until the actual results before worry about next steps.

Peanut butter is always my breakfast when I want to stay full for a while. When I am in a rush, I just eat a spoon of peanut butter and a glass of milk with some fruit. When I have a bit more time, I make toast with peanut butter. Cereal doesn't keep me full in general. I know you said you ...

My GI said the same thing, but he warned me that we would have to wait for the pathologist's report. Guess what? The report showed moderate to severe patches of intestinal damage. So, hang in there and just wait for those results.

What sort of side effects did you have? I feel like I still have acid every morning, upset stomach, bloating, burping, and poor tolerance to most food.