Symmetry? And Biopsy Location

[SpikeMoore]

Hi there

I am wondering if you must have a symmetrical rash to be DH. I only get rashes on one side or the other at one time, but they are suspicious for DH in all other respects.

Also wondering about the location of the biospy. Is it a lesion that should be sampled or an area of skin that is not in the rash that should be sampled? My GP took a lesion biopsy and it came back inconclusive. Went gluten free and haven't had any rashes since! (6 weeks now)

Any advice would be helpful.

Thanks

[teebs in WV]

Everyone is different - I am sure someone out there has DH that is not symmetrical - but it typically is (mine is). The biopsy needs to be beside a lesion - not an actual lesion. My biopsy was taken right beside one on my elbow and came back positive.

Good luck - I hope you figure out what your issue is. Although if the gluten-free diet has helped you I would definitely stick with it! It really isn't that bad after you get used to it - I try to look at it like "it could be worse".

[Sandyo]

Can you explain why the biopsy should be beside the lesion and not the actual lesion itself? I've been fighting a rash for three years now and they biopsied the lesion and told me it was Grover's Disease. It used to not ich but it's starting to. It goes away if I take Acutane. I've been gluten free for 6 months, but I'm sure I not as strike as I should be and I know I'm becoming more intolerant to gluten.

Sandy O

[teebs in WV]

I honestly do not know why - that is what I have read in my personal research. Someone else on here may know.

Anyone???

[BeverlyH]

Can you explain why the biopsy should be beside the lesion and not the actual lesion itself? I've been fighting a rash for three years now and they biopsied the lesion and told me it was Grover's Disease. It used to not ich but it's starting to. It goes away if I take Acutane. I've been gluten free for 6 months, but I'm sure I not as strike as I should be and I know I'm becoming more intolerant to gluten.

Sandy O

Hello Sandy O, I was diagnosed with Grover's Disease 2 years ago and it's gotten progressively worse. I do not fit the "mold" for Grover's. I'm a woman, have it on my scalp, arms, hands, trunk, and legs. All the cortissone creams on the planet haven't helped. I had to take Prednisone for an ecxema rash and the Grover's went away as did the ecxema, but Prednisone isn't recommended for Grover's. I haven't tried Accutane yet, but that's next on my list. The docs biopsy clear skin (non-lesion affected) so they can get an analysis of all potential skin diseases, not just the area that's affected. My father was allergic to gluten, so I'm going to try a gluten-free diet. I'm new on this forum, but will keep checking for new treatments for Grover's.

Beverly H

[tricialee]

Can you explain why the biopsy should be beside the lesion and not the actual lesion itself? I've been fighting a rash for three years now and they biopsied the lesion and told me it was Grover's Disease. It used to not ich but it's starting to. It goes away if I take Acutane. I've been gluten free for 6 months, but I'm sure I not as strike as I should be and I know I'm becoming more intolerant to gluten.

Sandy O

A positive biopsy consists of a specific microscopic appearance of granular deposits in the skin that are seen by a direct fluorescent antibody test for IgA-type antibody deposits. The deposits are widespread in the skin, and don't disappear until after months or even years on a gluten-free diet. Within the DH lesions, however, the pattern of granular deposits is disrupted or destroyed by the inflammation. Therefore, in order to see the classic pattern, it is necessary to biopsy the skin near a lesion, but not that skin directly involved in the blisters and rash.

Since the deposits in the skin are so widespread and long-lasting, doctors don't know why some areas are affected by lesions and others not, nor what triggers the attacks. Some correlations/theories I've seen include minor trauma to the skin, exposure to iodides, hormonal fluctuations, and, of course, increased ingestion of gluten.

[SpikeMoore]

Thanks for that excellent and concise explanation, Tricialee!