What About Cortisone?

[susiequsie]

I am gluten-free and have recently gone CF too. I've not been tested, but know from my reactions that I have these intolerances. Anyway, I recently developed a maddeningly itchy rash on my knee. My doctor prescribed a strong cortisone ointment (I had already tried a weaker one and it helped some) and the rash is almost gone.

My question: In trying to determine whether it might be DH or excema (short of having a biopsy), would the rash have responded to the cortisone if it had been DH?

[Mother of Jibril]

Nope... the only treatment that works for DH is dapsone and a gluten-free diet.

That doesn't mean your rash is unrelated to gluten! I had a biopsy for a gluten-related itchy rash that was mostly on my hands and arms (a little on my legs too)... made worse by hot showers. The pathologist labeled it, "spongiform, psoriasiform dermatitis." Which means... we don't know exactly what it is, but it's not DH and it's not scabies (or any other insects).

Actually, there are several types of itchy rashes that could be food intolerance-related... eczema, keratosis pilaris, psoriasis, and autoeczema (also called an "id reaction"). I'm not sure about KP (maybe someone else will know more), but the rest of these do respond to steroid treatment.

[missy'smom]

My son has eczema that responds to the cream but we did an elimination of gluten for a month and a half and it disappeared completely and didn't come back. When we reintroduced gluten, it came back. So we know that it is caused by wheat/gluten. He doesn't have an official diagnosis of celiac disease, but wheat showed up on allergy testing. See my signature.

[ravenwoodglass]

My question: In trying to determine whether it might be DH or excema (short of having a biopsy), would the rash have responded to the cortisone if it had been DH?

The best way to determine whether this is DH or not is the biopsy. It is a simple procedure where they take a small amount of the tissue next to the lesions. They then look for the antibodies in that tissue. It is not a painful procedure and the doctor will numb the area. If you suspect that the rash is DH you really should at least consider the biopsy as if that comes out positive you then have a definate celiac diagnosis.

I had severe DH and the topical cortizones did seem to help. I also took oral corticosteriods for it and those would work very well but of course soon the rash would be back because I was still consuming gluten.

[susiequsie]

Nope... the only treatment that works for DH is dapsone and a gluten-free diet.

That doesn't mean your rash is unrelated to gluten! I had a biopsy for a gluten-related itchy rash that was mostly on my hands and arms (a little on my legs too)... made worse by hot showers. The pathologist labeled it, "spongiform, psoriasiform dermatitis." Which means... we don't know exactly what it is, but it's not DH and it's not scabies (or any other insects).

Actually, there are several types of itchy rashes that could be food intolerance-related... eczema, keratosis pilaris, psoriasis, and autoeczema (also called an "id reaction"). I'm not sure about KP (maybe someone else will know more), but the rest of these do respond to steroid treatment.

Your reply is both informative and very helpful. That's what I needed to know. I've had excema many years ago (and as an infant too), so I'm glad to know what most likely it is. Thanks for your help.

[susiequsie]

My son has eczema that responds to the cream but we did an elimination of gluten for a month and a half and it disappeared completely and didn't come back. When we reintroduced gluten, it came back. So we know that it is caused by wheat/gluten. He doesn't have an official diagnosis of celiac disease, but wheat showed up on allergy testing. See my signature.

Thanks for your information, too. I have been gluten free for 6 or 8 months, but have recently decided I'd better do casein free, too. I was allergic to milk as a baby, covered in excema, and have experienced bouts of it off and on through the years. Even though I have drunk very little milk over the years, I'm sure I have gotten it in other ways.

[susiequsie]

The best way to determine whether this is DH or not is the biopsy. It is a simple procedure where they take a small amount of the tissue next to the lesions. They then look for the antibodies in that tissue. It is not a painful procedure and the doctor will numb the area. If you suspect that the rash is DH you really should at least consider the biopsy as if that comes out positive you then have a definate celiac diagnosis.

I had severe DH and the topical cortizones did seem to help. I also took oral corticosteriods for it and those would work very well but of course soon the rash would be back because I was still consuming gluten.

Oh my, now I am confused again. I thought I definitely decided that it was excema. So the cortisones did help? Well, I guess I'll have to think about it some more. The spot was not severe like yours was, at all, and is for the most part gone now after 1 week of the cortisone ointment.

I did have a biopsy a year ago for a sore on my leg. Turned out to be stasis dermatitis from poor circulation in my legs. It was a non-itchy sore and I now wear compression hose.

If this continues to be an ongoing problem, I will have it biopsied. Thanks for your help.