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Pustular psoriasis or DH?


Dee21

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Dee21 Apprentice

Hi everyone from NZ. My story is a wee bit long so will try to make it quick! I have had pustular psoriasis on my feet for 3 years, it has never been formally diagnosed as my nurse practitioner was sure that is what it is. I joined a fb group for pp and saw a lot of people saying they had success with a keto diet. So I tried it, I did an 'egg fast diet first to kick start it and within a week my feet were clearing up. It was like taking a pair of broken glass slippers off and my 'fibromyalgia symptoms started to disappear! I switched to regular keto and boom, I was ill. I can only describe it as being poisoned. I was soo ill. All of my symptoms returned and I was in bed for days and my feet started flaring again. I visited my np and she showed no interest at all as I have been ill for over 10 years and looked as I normally did. I went back to the group and someone suggested cutting out gluten which I did. Again everything started clearing up. 4 weeks in I could wear training shoes for the first time in years. I could walk, my joints didn't hurt and I felt fantastic. The only problem I had was I couldn't tolerate dairy so changed to lactose free milk and cut everything else out. I 'was still learning about gluten and accidentally poisoned myself again (toaster) and ended back at the np. By then, I was 6 weeks gluten-free and was just researching it properly. My np did a blood test which was false positive. I went back to her armed with the info and said it was too late to take my bloods and she was very dismissive of me, said 'Oh you know it's gluten, just don't eat it'. FF I made an appointment with the head GP at my surgery, sent him a letter in advance of my appointment and explained how ill I have been for years and that I want and deserve diagnosis. (I have sons who I now believe are celiac/GS. When these 'poisonings' as I call them happen, it's as if a huge black skip is falling on my head, depression isn't a strong enough word, I can't stop crying, all of my symptoms return and I feel I'm being poisoned. I had no idea how ill I have been until I got better for those few weeks and I want that back. My gp put me on a 4 week gluten challenge, it has been utter hell and thankfully I have my bloods taken tomorrow. My symptoms during these 4 weeks have changed almost daily, just like my fibro, but worse. Some have been in the front of my mind where they used to be the ones I just coped with as others were worse. My bloating/gas/D/ have been so bad, I felt like I had eaten glass and actually felt my skin as was sure this shards were sticking out! My knees hurt so bad I couldn't get up stairs for the first 3 weeks, my usual pain was everywhere but not my knees before this! I woke one morning and all I could taste was salt for 4 hours. I've been weepy on and off the whole time.. The first week of returning to regular milk was hell, I felt soo sick all the time. My feet flared up within 2 days, I have attached pics showing the different stages of them before gluten-free, during and now. I am also having what I can only describe as nerve pain in my arms and back (and the return of the itchy blisters on my fingers and hands that I've had on and off for years too). First of all I have an itch, it isn't too bad, then a teeny blistery bump, then agony, and the next day it has turned into a red dot or blotch. I have had this happen on and off for years but it is worse this time. I'm now beginning to think this is DH and not psoriasis at all and would love to hear your thoughts. So sorry for the awful ugly photos! Have just realised I can only add 3 at a time so will put the others in comments. 

118951876_442111260096468_5232462336050121525_n.webp

118889878_691295558401141_5955330028796275145_n.webp

122383210_2095881520548262_5551960125244920129_n (2).webp

Just now, Dee21 said:

 

 

 

122348809_990499561469088_7574313791108537138_n.webp

122838846_390420405315086_4068433883962138447_n.webp


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Dee21 Apprentice
2 minutes ago, Dee21 said:

 

New blisters on arms back etc.


 

 

123491521_662605107759097_3711300939833580273_n.webp

123465945_1446907218833020_7941615213630561519_n.webp

123072083_625088968160712_4830229172791215786_n.webp

123135511_374546330565370_7852638828146449576_n.webp

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    • trents
      Let me hasten to add that if you will be undergoing an endoscopy/biopsy, it is critical that you do not begin efforts to reduce gluten beforehand. Doing so will render the results invalid as it will allow the small bowel lining to heal and, therefore, obscure the damage done by celiac disease which is what the biopsy is looking for.
    • Scott Adams
      This article, and the comments below it, may be helpful:    
    • Scott Adams
      That’s a really tough situation. A few key points: as mentioned, a gluten challenge does require daily gluten for several weeks to make blood tests meaningful, but negative tests after limited exposure aren’t reliable. Dermatitis herpetiformis can also be tricky to diagnose unless the biopsy is taken from normal-looking skin next to a lesion. Some people with celiac or DH don’t react every time they’re exposed, so lack of symptoms doesn’t rule it out. Given your history and family cancer risk, this is something I’d strongly discuss with a celiac-experienced gastroenterologist or dermatologist before attempting a challenge on your own, so risks and benefits are clearly weighed.
    • Greymo
      https://celiac.org/glutenexposuremarkers/    yes, two hours after accidents ingesting gluten I am vomiting and then diarrhea- then exhaustion and a headache. see the article above- There is research that shows our reactions.
    • trents
      Concerning the EMA positive result, the EMA was the original blood test developed to detect celiac disease and has largely been replaced by the tTG-IGA which has a similar reliability confidence but is much less expensive to run. Yes, a positive EMA is very strong evidence of celiac disease but not foolproof. In the UK, a tTG-IGA score that is 10x normal or greater will often result in foregoing the endoscopy/biopsy. Weaker positives on the tTG-IGA still trigger the endoscopy/biopsy. That protocol is being considered in the US but is not yet in place.
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