Is Is Psoriasis Or Is It Dh?

[momxyz]

I would like to start a discussion of this as I do not have a confirmed diagnosis of my rash. I suspected DH because of the intense itching and so decided to go gluten free. I have experienced both improvement, and two episodes where the itchiness returned - both associated with ingesting gluten.

But being a devil's advocate I asked myself "But what if it's not DH?"

So I go googling and guess what I find: an asociation between celiac's and/or gluten intolerance and psoriasis. ( I also found an article demonstrating improvement for psoriasis sufferers if they followed a gluten free diet.) So I google lots of images - and guess what - some forms of psoriasis look a lot like pictures of DH......

so now I am curious about the differences between these two entities and hope some of you will chime in on a discussion of that.

[mushroom]

  momxyz said:

I would like to start a discussion of this as I do not have a confirmed diagnosis of my rash. I suspected DH because of the intense itching and so decided to go gluten free. I have experienced both improvement, and two episodes where the itchiness returned - both associated with ingesting gluten.

But being a devil's advocate I asked myself "But what if it's not DH?"

So I go googling and guess what I find: an asociation between celiac's and/or gluten intolerance and psoriasis. ( I also found an article demonstrating improvement for psoriasis sufferers if they followed a gluten free diet.) So I google lots of images - and guess what - some forms of psoriasis look a lot like pictures of DH......

so now I am curious about the differences between these two entities and hope some of you will chime in on a discussion of that.

During your googling, you may have found this description of psoriasis:

"There are several forms of psoriasis. The most common form shows reddened areas a few inches across covered by silvery scales. Dermatologists refer to the affected areas as areas as "plaques". Other patterns psoriasis can appear in are "inverse" (shiny, red patches in areas of friction such as in the folds of skin in the groin, the armpits or under the breasts), pustular (blisters of noninfectious pus on red skin), or "erythrodermic" (reddening and scaling of most of the skin)." This is taken from the AOCD website.

I have been diagnosed with psoriatic arthritis, and have had both plaque psoriasis and inverse psoriasis. I have not had the pustular or erythrodermic kinds, so nothing I have vaguely resembles my husband's DH which produced a very angry-looking blistery rash on his forehead with the blisters bursting and then leaving a purple scar which took weeks to fade. I suspect you might be thinking you could have the pustular psoriasis. Since I have not had experience of this I can make no comparison between that and my husband's DH. It does seem that DH is more intensely itchy than psoriasis, although that itching was bad enough. Husband's DH cleared once he eliminated gluten; the gluten free diet had absolutely no effect on my psoriaris or my arthritis, unfortunately. It was not until I began taking Humira (adalimumab) injections that these got better. All the steroid and other creams also had minimal impact--just kept the psoriasis from getting out of control altogether.

I don't know if this is any help....

[momxyz]

actually this is both interesting and helpful. You surmised correctly, I was thinking of the pustular form of Psoriasis. From what I have read, everyone's response and time to heal - for both entities - varies. Although the pretty common theme I hear is patience is required!

Initiallly I thought this had to be DH because I was able to see improvement, tho slow, from the diet. Prior to the diet no cream or ointment seemed to help and at least now some areas are clearing up. That, plus the reaction I had from eating gluten pretty much convinced me.

But I did find one dermatological journal article - I'll see if I can find it later - where the authors were pretty impressed by the improvements seen in their psoriasis patients while on the gluten free diet. And they observed worsening with patients who went off the diet. I am not denying your experience, because while it is pretty clearly documented in the scientific literature that DH always benefits from a gluten free diet, the connection between gluten and psoriasis, while present here and there in the scientific literature, doesn't seem to yet be universally accepted. (Otherwise psoriasis suffers would be adivsed to go gluten-free!)

I know I am not trained to evaluate rashes and someday (when money is not an issue) I will need to take myself to a physician. (perhaps after an accidental glutening.... I am having no more intentional ones!!!!!) But I found a couple of pictures of the various forms of psoriasis that looked like other pictures of DH! I couldn't help but think how easy it would be for someone to be misdiagnosed.

my healed lesions do leave a purplish spot that fades to light brown, and these cute little polka dots are still evident, another thing that points to DH it would seem.

[nasalady]

  momxyz said:

actually this is both interesting and helpful. You surmised correctly, I was thinking of the pustular form of Psoriasis. From what I have read, everyone's response and time to heal - for both entities - varies. Although the pretty common theme I hear is patience is required!

Initiallly I thought this had to be DH because I was able to see improvement, tho slow, from the diet. Prior to the diet no cream or ointment seemed to help and at least now some areas are clearing up. That, plus the reaction I had from eating gluten pretty much convinced me.

But I did find one dermatological journal article - I'll see if I can find it later - where the authors were pretty impressed by the improvements seen in their psoriasis patients while on the gluten free diet. And they observed worsening with patients who went off the diet. I am not denying your experience, because while it is pretty clearly documented in the scientific literature that DH always benefits from a gluten free diet, the connection between gluten and psoriasis, while present here and there in the scientific literature, doesn't seem to yet be universally accepted. (Otherwise psoriasis suffers would be adivsed to go gluten-free!)

I know I am not trained to evaluate rashes and someday (when money is not an issue) I will need to take myself to a physician. (perhaps after an accidental glutening.... I am having no more intentional ones!!!!!) But I found a couple of pictures of the various forms of psoriasis that looked like other pictures of DH! I couldn't help but think how easy it would be for someone to be misdiagnosed.

my healed lesions do leave a purplish spot that fades to light brown, and these cute little polka dots are still evident, another thing that points to DH it would seem.

My husband seems to have BOTH psoriasis (very bad on his hands) and DH. His dermatologist initially diagnosed psoriasis and eczema, but I noticed popped blisters which turned dark purple as they healed.....the purple spots take literally MONTHS to go away.

You're correct in that purple spots during healing is classic DH behaviour, and I think that's the only blistery rash out there which develops purple spots as it heals.

My husband is still struggling with his skin conditions, even though he has been gluten free since January. His DH has improved to some extent, although he still gets breakouts they're not as bad as his initial episode. My own plaque psoriasis is much better on the diet, and our kids have seen significant improvements in their eczema and keratosis pilaris!

Things should continue to improve for you if you remain on the gluten free diet....

Hang in there!

JoAnn

P.S. There is a test you can perform at home to see if you do have DH or not. It's called the iodine patch test; it used to be the standard test for DH. Here are a couple of links to discussions of the iodine patch test on this forum if you're interested:

https://www.celiac.com/gluten-free/index.php?showtopic=57732

https://www.celiac.com/gluten-free/index.php?showtopic=61119

[momxyz]

yes, I have read about the iodine test. Do you think it would still be positive after 8 weeks on the gluten free diet?

[nasalady]

  momxyz said:

yes, I have read about the iodine test. Do you think it would still be positive after 8 weeks on the gluten free diet?

I think it should be positive any time you have active DH blistering, even if you're gluten free....it may even work without visible DH activity.

[nasalady]

Ah ha!....here is the answer to your question:

"When one is still eating Gluten and still breaking out with DH, the iodine test will also cause reaction. After you have become gluten-free and the DH is completely gone, it will stop working too. Eating a lot of iodine during the breakout phase can also exacerbate the reaction - so some say to eat non-iodized salt TEMPORARILY. One still needs iodine in the diet to live and once the DH goes away from being gluten-free, you should probably go back to regular salt."

This is from the second post on the following thread:

https://www.celiac.com/gluten-free/index.php?showtopic=57732

[momxyz]

thanks for the answer!

its been 10 days since the appearance of the last new blister. Plus some of the more persistent older spots are doing much better.... they no longer look like craters! And the itch factor is way down. Which is a good thing, because my nails are growing like crazy and can now do way more damage!

I hope you and your husband continue to improve and get relief...

[lovegrov]

I've had both and they weren't the slightest bit alike other than some itchiness (the DH was MUCH itchier). My DH was in the form of blisters filled with clear fluid, much like a burn. The itching was horrendous. Since going gluten-free, the DH is gone.

My psoriasis is mostly these flaky patches that can also be itchy, but NOTHING even close to the itchiness of the DH.

I've heard DH described as like having poison ivy while being wrapped in a wool blanket filled with red ants. I'd agree.

richard

[nasalady]

  lovegrov said:

I've had both and they weren't the slightest bit alike other than some itchiness (the DH was MUCH itchier). My DH was in the form of blisters filled with clear fluid, much like a burn. The itching was horrendous. Since going gluten-free, the DH is gone. My psoriasis is mostly these flaky patches that can also be itchy, but NOTHING even close to the itchiness of the DH.

Hi Richard,

There are many different types of psoriasis; one of the rarest is palmoplantar psoriasis. Here are some pictures:

Open Original Shared Link

As you can see, it is a blistery rash. The kind of psoriasis that I have is plaque psoriasis, which looks quite different....it sounds as though you might have the same.

Cheers,

JoAnn