What Test To Ask For...

[buffettbride]

Hubby wants to get tested for DH because we are thinking that is what on his hands. We do know that when he doesn't eat gluten, the rash subsides. When he eats gluten, it flares back up.

He's getting the deer-in-headlights response from places he's called, but he's not exactly a stellar phone communicator.

What test should he ask for?

Is he better off calling a dermatologist? Allergist? Gastro? Ack!!!!

[ItchyMeredith]

I went to a dermatologist and got a skin biopsy adjacent to the blister. They have to take a little bit of skin next to the rash to look for IgA deposits. The actual blister does not have the IgA so it is important to get a dermatologist who knows how to do this biopsy.

Good Luck!

[happygirl]

From: Open Original Shared Link

"Q: What is dermatitis herpetiformis?

DH is the skin manifestation of celiac disease. It is characterized by an extremely itchy, watery blister or rash that is found on the limbs, trunk, face and scalp. The blisters are often mirrored on both sides of the body or face and reoccur in the same areas. The eruptions are often mistaken for and treated as other skin conditions including psoriasis, infected mosquito bites, contact dermatitis, allergies or "non-specific dermatitis."

DH is a chronic, permanent condition and, if not treated with a gluten-free diet, may cause gastrointestinal symptoms at a later date whether or not the intestines shows damage initially. Less than 10% of patients with DH have GI symptoms, yet if you have DH, you always have celiac disease.

DH is diagnosed by a small skin biopsy at the edge of an eruption. This must be done by a knowledgeable dermatologist as a sampling of tissue from the wrong section of the eruption can be confused with other skin conditions.

The current treatment of DH is two-fold:

1- A strict adherence to a gluten-free diet.

2- The use of medications to relieve the itching and burning of the blisters.

Dapsone is the usual drug of choice. Baseline blood tests should be performed prior to treatment with Dapsone and blood work should be done at regular intervals thereafter. Medications should be taken in the smallest effective doses for as short a time as possible and monitored by a physician.All of the ingested drugs have numerous potential side effects, some extremely severe.

Topical creams containing cortisone and steroids are also prescribed to alleviate symptoms. None of these drugs eliminate the cause of the eruptions or the IgA deposits within the skin, they simply suppress the symptoms.

Q: What triggers DH?

The simple answer is ingested gluten. But iodine (potassium iodide, iodized salt, kelp), some anti-inflammatories and stress can exacerbate the disease. An area of controversy is whether or not gluten can be absorbed through the skin. Most medical experts say no, only dietary gluten is of concern.

DH can be "exquistely sensitive" to gluten. Since the skin may not be rid of the IgA deposits for 2+ years after starting a gluten-free diet, flare-ups may continue to occur. The skin response is much slower compared to the healing of the intestinal mucosa. In particular, outbreaks of facial and scalp lesions while on otherwise adequate treatment is not uncommon."

[MDRB]

Your general practitioner should be able to do a skin biopsy, or you could go to a dermatologist. Just make sure that you ask for a proper biopsy for dermatitis herpetiformis otherwise they will just take a skin scraping which is totally useless for diagnosing DH.

Good luck