Skin biopsy

[Conniem]

Hi everyone

My daughters recent blood test for celiac disease was negative. This was done after she developed an intensely itchy, blistery rash (both elbows, both forearms, hairline, lower back, behind both ears,  sternum). It did not respond to any treatments. GP said it looks very like DH. She is seeing a dermatologist tomorrow but wouldn’t you know, the rash has suddenly all but disappeared. It did this before, faded away for a few days and then came back. I know the biopsy is taken from skin close to the rash but can it go ahead if there isn’t any active rash? There are one or two blistery spots left and where the rash was is scarred. And can DH die back and flare up again? Thanks 

 

 

[knitty kitty]

@Conniem,

Welcome to the forum!  

The rash may flare again if gluten is consumed.  Iodine (as in salt, dairy, and shellfish) can cause DH flares.

Yes, the DH can fade and flare for weeks after an exposure to gluten.

Genetic testing for Celiac genes might be more conclusive.  

People who have DH can test negative on Celiac blood tests.  My antibody test was negative, but I had active DH.  I was diagnosed with a positive genetic test and improvement on a gluten free diet.  

Hope this helps!

[Rogol72]

@Conniem,

I have DH which was diagnosed by skin biopsy for what was initially thought to be Eczema. Coeliac blood test was negative as was a subsequent endoscopy and small bowel biopsy for celiac disease. My forearms have the tell tale scars from blisters in previous flare ups. As knitty kitty said, Iodine in Dairy can flare it. Our salt is not iodised in Europe. From what I've read and experienced, people with DH are far more sensitive to small amounts of gluten well below 20ppm than most Coeliacs.

[knitty kitty]

Sea salt has iodine in it naturally.

[Tamber]

Your daughter sounds just like me! I have gluten sensitivity and then one day I broke out in a blistery rash on my arms, legs and buttocks. The dermatologist thought it was DH but the test came back negative.  It eventually cleared up, kept coming back but to a lesser extent and then switched to my face. And many, many dermatologists later, they still had no answers. Thats the bad news.

The good news - you and your daughter can take control. Keep a food journal of what she eats and what happens with her skin. Or, do an elimination diet, start with a strict diet and slowly add back in more foods. Also take photos of the break outs. A picture is worth a thousand words. The process may be slow but while seeing doctors, its worth it to see if you two can add insight to the mystery.

While there may be many root causes, my problem was with Histamines - processed foods, left overs, champagne, even too much sunlight and perspiration plus many moisturizers and makeups. Im working on healing my gut, watching my diet so  my itchy bumps are finally under control. 

Good luck!

[Conniem]

Thanks for all responses. So the rash all but disappeared. The dermatologist said it looked like many things but was not definite for any one thing and she couldn’t do a biopsy as there was no active rash. But now just less than a week later her ears (the rims,  behind the ears and also on the nape of her neck) have broken out again, red, inflamed, burning and itching with yellow looking blisters that popped and dripped fluid down her neck, almost looks like a burn, but it’s not a burn. Now the blisters area has dried up but the skin is red and inflamed and very very itchy. She has red/purple spots on her scalp near the hair line and around the edge of the hairline, but nothing has returned in her back or elbows or hands yet. We have managed to arrange a biopsy for Wednesday. I don’t know what to make of it all.