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Dermatitis Herpetiformis (DH, Duhring's Disease) is a chronic condition, but according to the Celiac Disease Foundation it only affects 10 - 15% of people with Celiac Disease. These itchy little "Blighters" are caused by gluten ingestion. Symptoms can tend to come and go, and DH is commonly diagnosed as eczema. Symptoms normally resolve with a strict, gluten-free diet. {I underline "Normally" because you can suddenly get some itching and this DH rash on your thighs and wonder what on earth you ate in the last two weeks that caused this DH rash. Got news for you; it can be showing its miserable self a month after you ingested gluten, so don't give up the Celiac Diet, Persevere.  Did you know that "Atypical" Dermatitis Herpetiformis can be diagnosed as atypical oral or genital lesions. About nine years ago I presented at the Emergency Room of our local hospital with mouth sores. I mean these sores were hanging from my upper palette , must have been down my throat, all over the insides of my cheeks and it hurt so bad.  I had an Emergency Doctor who had never heart of the word  "Tact" or "Kindly" or even "Gently".  I was hurting, I was upset because we were leaving the next week to see my family in England.  This Emergency Doctor actually asked me if I had numerous sexual partners, or did I know about my husband "visiting" around.  That made me so angry, first because the lesions had never been swabbed to determine what they were. Secondly, we had been happily married for over 40 years, and we are like "Mutt and Jeff", you see me, you see my husband, like the Bobsey Twins. I am dating myself I know.  I was given a mouth wash and an antibiotic, and the next morning you can be sure I was at my own doctor's office with a list of questions.  This E.R. Doctor had not taken my medical history, which in training, you learn to do first before you present a patient with that type of observation. I was so sick; I could not swallow anything except Ensure and chopped ice cubes. Slowly it went away. They did find out that it was Dermatitis Herpetiformis, but that took five days to find out the correct diagnosis.  I tell you this because not all doctors know about DH.  One doctor presented his color coded book of lesions and asked me if my sores fit into one of the pictures. I so wanted to go back to the Emergency Department and find that E.R. Physician and show him the biopsy sheet, or tell him what his loud voiced diagnosis had done to me. My GP told me not to worry, that it likely occurred because I was anxious that everything was being jammed into suitcases and it stressed me. My GP told me to leave it to him; which I did, and he actually looked up the doctor and told him that his type of diagnosis in a full Emergency Department would leave any woman in tears. I left it at that.  But it taught me something BIG about DH. It does run in cycles; it partners stress so you often find it appears on the skin at a stressful time in your life. When a person with celiac disease consumes gluten the mucosal immune system in the intestine responds by reducing a type of antibody called immunoglobulin A (IgA).

CDF Medical Advisory Board Member and Chairman of the Department of Dermatology at the University of Utah School of Medicine states that these IgA antibodies are directed against epidermal transglutaminase. The antibodies then travel to the skin where they bind with the epidermal transglutaminase protein. Gluten ingestion seems to trigger this reaction. These DH sores, that always seen to run in lines, and take up residence in the same places, most of the time, and that is because they do not leave you, they hide from you under the skin. The moment you eat gluten or are extremely stressed out they come again. That is why the old way of determining or diagnosing dermatitis herpetiformis was putting some Iodine on the areas where you continuously get these DH sores. Then you have your own little batch of DH sores without eating gluten.

If you find this seriously light Blog makes you smile, and could possibly read more, please respond back to me on the BLOG and I will chat with you about the article, "When Celiac is Skin Deep". I thoroughly enjoyed it, received some education from it, and would love to "pass it on". Only as we become a TEAM will we be able to keep people informed about Celiac Disease and Dermatitis Herpetiformis. Also, a friend will not call you, prior to her making dinner, and ask you if potatoes are gluten free.

Yvonne (Vonnie) Mostat,

Celiac Journal of Gluten Sensitivity BLOG SITE



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