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Help! Could this be DH on the scalp?


FitnessMom

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FitnessMom Newbie

Help! Type 1 diabetic here with horrible skin rash that itches and burns on scalp and legs only  My Derma said it’s folliculitis. My twin has Celiac. I’ve had this rash since June and have tied soooo many creams, Rx, shampoos. 


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Scott Adams Grand Master

Since your twin has celiac disease that means you have an approximately 44% chance of also having it. Have you ever had a blood test for celiac disease? All first relatives of people with celiac disease should be screened regularly for it due to their high risk of also having it. 

I recommend you get a blood screening for it, and you need to keep eating gluten daily until you do this test. Also, would your dermatologist be open to doing a biopsy for DH?

FitnessMom Newbie
2 minutes ago, Scott Adams said:

Since your twin has celiac disease that means you have an approximately 44% chance of also having it. Have you ever had a blood test for celiac disease? All first relatives of people with celiac disease should be screened regularly for it due to their high risk of also having it. 

I recommend you get a blood screening for it, and you need to keep eating gluten daily until you do this test. Also, would your dermatologist be open to doing a biopsy for DH?

Thanks for the fast reply! I had a blood test and all came back normal. My Derma isn’t opposed to the DH biopsy but he said since I mainly have head sores that he would have to biopsy skin next to the sores ?! So he said on my neck! Have you or anyone seen people with horrible side of the head sores?! I’ve tired everything!!! Ugh. 😕 

trents Grand Master
(edited)

DH is one of the classic manifestations of celiac disease but your blood test does not indicate you have celiac disease. So maybe your rash is something else. On the other hand, we sometimes see negative antibody test results when people actually do have celiac disease.

Specifically, what celiac antibody tests did your physician run? Many will only run the tTG-IGA instead of a full celiac antibody panel and so will miss some celiac diagnoses. Can you post the results of your blood test with reference ranges to indicate what is normal?

Edited by trents
knitty kitty Grand Master

@FitnessMom,

Does your rash get worse when exposed to the sun?

Welcome to the forum! 

CeCe22 Explorer
On 9/17/2021 at 9:56 PM, knitty kitty said:

@FitnessMom,

Does your rash get worse when exposed to the sun?

Welcome to the forum! 

Heading to beach with family soon. Does DH get worse when exposed to sun?

Scott Adams Grand Master

It did for me, as I had it for years in only one small spot on the back of my lower thumb joint. Interestingly, and I’m talking about the mid 90’s here, I had a dermatologist recommend UV treatment as a therapy, which I never tried. I did, however, badly sunburn (imagine the entire area on the back of each of your hands as one big blister!) the backs of my hands on a high mountain fishing trip and my DH went away, never to return. I definitely don’t recommend this approach. I was gluten-free through this time period, but was likely getting contamination when eating out.


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knitty kitty Grand Master
11 hours ago, CeCe22 said:

Heading to beach with family soon. Does DH get worse when exposed to sun?

Yes, my DH got worse with exposure to the sun. 

DH is pressure sensitive.  Have you tried sleeping on the other side of your head? 

I would get DH blisters on the palms of my hands after pushing the grocery carriage through the store.  And I would get DH blisters under any elastic in my clothing (bra, undies, waistbands, etc.).  

Also I had Niacin (Vitamin B3) deficiency which results in a rash on head, neck, hands and forearms, and lower legs and feet, as well as weird skin pigmentation when exposed to the sun, which doesn't go away. 

I had Cobalamine (B12) deficiency as well which causes spotted skin pigmentation anywhere skin is exposed to the sun, which doesn't go away either.  This looks different than freckles and the Niacin deficiency pigmentation. 

So splotchy me.  Heavy sigh.  

It's my understanding a dermatologist should sample skin near or next to a lesion, like next to a lesion on your head, not in an unaffected area like your neck.  

I'm Type Two Diabetic.  I found taking thiamine (Vitamin B1) helps with glucose metabolism.  Thiamine also helps Type One Diabetics, too.  Here's a couple of articles....

Thiamine Level in Type I and Type II Diabetes Mellitus Patients: A Comparative Study Focusing on Hematological and Biochemical Evaluations

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282352/

And... Fact Sheet...

https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/

Vitamin deficiencies can occur with or without Celiac Disease.

Hope this helps! 

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    • Scott Adams
      This is a very common question, and the most important thing to know is that no, Guinness is not considered safe for individuals with coeliac disease. While it's fascinating to hear anecdotes from other coeliacs who can drink it without immediate issues, this is a risky exception rather than the rule. The core issue is that Guinness is brewed from barley, which contains gluten, and the standard brewing process does not remove the gluten protein to a level safe for coeliacs (below 20ppm). For someone like you who experiences dermatitis herpetiformis, the reaction is particularly significant. DH is triggered by gluten ingestion, even without immediate gastrointestinal symptoms. So, while you may not feel an instant stomach upset, drinking a gluten-containing beer like Guinness could very well provoke a flare-up of your skin condition days later. It would be a gamble with a potentially uncomfortable and long-lasting consequence. Fortunately, there are excellent, certified gluten-free stouts available now that can provide a safe and satisfying alternative without the risk.
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      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
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