Jump to content
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

DH biopsy question


artistsl

Recommended Posts

artistsl Enthusiast

I have had an incredibly itchy rash on my knuckles since 2004. It drives me nuts. Keeps me awake at night sometimes. I went gluten free and after 6 months on this new diet the rash disappeared for the first time in 13 years! I was amazed. My annoying rash along with joint pain, fatigue and brain fog just totally  disappeared. It was like I had stumbled upon a great new world. I then read about something called DH and how if you suspect gluten sensitivity then your rash should be biopsied. So I visited with my dermatologist and she said that she will perform a biopsy. She told me to eat gluten and then call her when the area starts to form a blister. I've read about gluten challenges and how you need to eat gluten daily for 12 weeks or some crazy amount of time for the antibodies to show in your bloodwork. Typically when I eat gluten it takes only 2-6 hours for my rash to form a blister (they are tiny blisters that look like poison ivy). My dermatologist told me that sometimes it can take 3-4 biopsies in order to test positive. So my question is do I need to eat several weeks worth of gluten in order to test positive for DH? It takes one piece of bread for me to form a tiny blister and she said to call her when the area starts to form a blister. I'm afraid that if I don't eat enough though then it may come back negative. 


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



squirmingitch Veteran

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Short answer:

Yes, you need to do a gluten challenge or you can easily turn up with a false negative on the dh biopsy.

Jmg Mentor

What is your objective? If it's a diagnosis then you should prepare for a gluten challenge, you could also ask about a celiac blood test to improve your chances of a diagnosis. It can be rough going, but it's the only way to get accurate test results. Be warned however, some people with a gluten problem won't test positive and there's no treatment at the end other than a gluten-free diet (and maybe some dapsone or similar for the rash). 

If you do the challenge keep a food diary and start a thread on here for advice and moral support :) best of luck whichever path you choose!

artistsl Enthusiast

This is exactly the information I needed! Thanks guys!

artistsl Enthusiast
On 6/7/2017 at 6:05 AM, squirmingitch said:

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

Short answer:

Yes, you need to do a gluten challenge or you can easily turn up with a false negative on the dh biopsy.

On 6/7/2017 at 6:36 AM, Jmg said:

What is your objective? If it's a diagnosis then you should prepare for a gluten challenge, you could also ask about a celiac blood test to improve your chances of a diagnosis. It can be rough going, but it's the only way to get accurate test results. Be warned however, some people with a gluten problem won't test positive and there's no treatment at the end other than a gluten-free diet (and maybe some dapsone or similar for the rash). 

If you do the challenge keep a food diary and start a thread on here for advice and moral support :) best of luck whichever path you choose!

My intent is to get a positive on the DH. I guess I'm questioning the duration of a food challenge. My dermatologist told me to just eat gluten and call her next week when a blister starts to form. It only takes 2-6 hours for me to develop a blister after eating gluten. I guess I'll give it a couple of days of eating gluten and then call her back just to be sure. Sorry, this is all so confusing to me. Science really needs to get on the ball to develop a test that can diagnose immediately. 

Jmg Mentor
1 hour ago, artistsl said:

My intent is to get a positive on the DH. I guess I'm questioning the duration of a food challenge. My dermatologist told me to just eat gluten and call her next week when a blister starts to form. It only takes 2-6 hours for me to develop a blister after eating gluten. I guess I'll give it a couple of days of eating gluten and then call her back just to be sure. Sorry, this is all so confusing to me. Science really needs to get on the ball to develop a test that can diagnose immediately. 

Yes that would be awesome!  I guess if the blisters are forming the reaction is ongoing and the antibodies should be there. It certainly seems logical. I like that your dermatologist is prepared to go back 4 times to establish, sounds like she understands its a difficult one to pin down.  

I hope you update us on how you go on. The last time I ate gluten in some quantity I got very itchy rash on elbows very quickly. So I often wonder if I got glutened again and it appeared if I'd be better trying to get that tested than trying for blood tests again. I dont plan on eating the gluten but I am v interested!

Best of luck :)

 

 

squirmingitch Veteran

You have to eat gluten for 12 weeks EVEN for the dh biopsy. Not just a few days. 


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Jmg Mentor
1 hour ago, squirmingitch said:

You have to eat gluten for 12 weeks EVEN for the dh biopsy. Not just a few days. 

Ah shucks :(

 

artistsl Enthusiast

I called my dermatologist back and she said that it needs to be biopsied when a blister is starting to form. This makes sense to me because if I were to perform a twelve week gluten challenge then by that time the area in question would likely be all scab and no longer show any blistering. I'm going to try her method and let you know how it goes. I made an appointment for July 5th because my blisters are usually predictable and form within 2-6 hours after consumption. I'm relying on that consistency for the biopsy. 

Jmg Mentor

Good luck, hope you get the answers and certainty you seek. Remember if tests are negative there's nothing to stop you returning to the gluten-free diet, you already know it can resolve your symptoms. :)

 

Archived

This topic is now archived and is closed to further replies.


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      131,892
    • Most Online (within 30 mins)
      7,748

    RyanDunn
    Newest Member
    RyanDunn
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      121.4k
    • Total Posts
      1m

  • Celiac.com Sponsor (A22):




  • Who's Online (See full list)


  • Celiac.com Sponsor (A21):



  • Upcoming Events

  • Posts

    • JulieRe
      Hi Everyone,  I do appreciate your replies to my original post.   Here is where I am now in this journey.  I am currently seeing a Naturopath.  One thing I did not post before is that I take Esomeprazole for GERD.  My Naturopath believes that the decrease in the gastric acid has allowed the yeast to grow.    She has put me on some digestive enzymes.  She also put me on Zinc, Selenium, B 12, as she felt that I was not absorbing my vitamins. I am about 5 weeks into this treatment, and I am feeling better. I did not have any trouble taking the Fluconazole.  
    • Ceekay
      I'm sure it's chemically perfect. Most of them taste lousy!        
    • Rejoicephd
      Hi @JulieRe.  I just found your post.  It seems that I am also experiencing thrush, and my doctor believes that I have fungal overgrowth in my gut, which is most likely candida.  I'm seeing my GI doctor next week, so I'm hoping she can diagnose and confirm this and then give me an antifungal treatment.  In the meantime, I have been working with a functional medicine doctor, doing a candida cleanse and taking vitamins. It's already helping to make me feel better (with some ups and downs, of course), so I do think the yeast is definitely a problem for me on top of my celiac disease and I'm hoping my GI doctor can look into this a bit further.  So, how about you?  Did the candida come back, or is it still gone following your fluconazole treatment?  Also, was it awful to take fluconazole?  I understand that taking an antifungal can cause a reaction that sometimes makes people feel sick while they're taking it.  I hope you're doing better still !
    • Scott Adams
      I'm so sorry you're going through this—the "gluten challenge" is notoriously brutal, and it's awful to deliberately make yourself sick when you've already found the answer. For the joint pain, many people find that over-the-counter anti-inflammatories like ibuprofen can help take the edge off, and using heating pads or warm baths can provide some direct relief for the aches. For the digestive misery, stick to simple, easy-to-digest foods (like plain rice, bananas, and bone broth) and drink plenty of water and electrolytes to stay hydrated. It feels like the longest month ever, but you are doing the right thing to get a clear diagnosis, which can be crucial for your long-term health and getting the proper care. Hang in there; you can get through this! This article, and the comments below it, may be helpful:    
    • Scott Adams
      Daura Damm (a sponsor here) uses AN-PEP enzymes and filtering in their brewing process to reduce/remove gluten, and it actually tests below 10ppm (I've see a document where they claim 5ppm). 
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.