Going To The Derm One Last Time...some Questions

[mhalpin12]

I decided to try and get one last biopsy of my skin done. The last one done for DH was done incorrectly (taken from lesion directly instead of from unaffected skin near lesion), and I just have to try one more time to see if I can get a correct biopsy and a positive result. I'm nutso, I guess. It's still bothering me that I've embarked on the GFD without a positive medical test.

Question: I've been gluten-free for 3 days, biopsy is tomorrow. Is that short amount of time gluten-free going to affect the biopsy? Should I load up on cookies today, just to make sure? From what I've read and researched about the mechanism of DH, the IgA antibodies take a LONG time to leave the skin (which is why GFD takes so long to get rid of DH), so I'm thinking it's fine to get the biopsy tomorrow, since the rash is still plenty active after only 3 days gluten-free.

Second question: How close/far from the DH lesion should the biopsy be taken? I know it has to be next to it, but that's not that clear. A cm? An inch? Any ideas?

Any help you kind people can give me is so appreciated. You've been so helpful already, and provided me with so much information and support. Many thanks!

Michelle in TN

[ravenwoodglass]

If you have an active lesion 3 days gluten free will not effect the test. I tried to get the link to the NIH's Celiac Awareness Campaign but it wouldn't open. You could try doing a search with the words NIH and Dermatitis Herpeformis and see if it will come up. It should give you the info you need. I would ask the derm if he has ever biopsied for DH and if he is familiar with the way to do it.

[mhalpin12]

If you have an active lesion 3 days gluten free will not effect the test. I tried to get the link to the NIH's Celiac Awareness Campaign but it wouldn't open. You could try doing a search with the words NIH and Dermatitis Herpeformis and see if it will come up. It should give you the info you need. I would ask the derm if he has ever biopsied for DH and if he is familiar with the way to do it.

Thank you, Ravenwood...I did find that article, printed it up, highlighted the section on proper biopsy, and took it to the doctor. She barely glanced at it (Grrrrrrr....), but she DID listen to my whole story, agreed to do a biopsy of unaffected skin and perilesional skin on my bum, and sent it to a lab better known for doing DH biopsies. It's the best I can hope for. She looked at me like I was some kind of loony, but who cares? I got what I needed from her; get the results in a week. If it comes back negative, I don't know what I'll do. I'm still gluten-free for now.

Michelle in Tn

[ravenwoodglass]

Thank you, Ravenwood...I did find that article, printed it up, highlighted the section on proper biopsy, and took it to the doctor. She barely glanced at it (Grrrrrrr....), but she DID listen to my whole story, agreed to do a biopsy of unaffected skin and perilesional skin on my bum, and sent it to a lab better known for doing DH biopsies. It's the best I can hope for. She looked at me like I was some kind of loony, but who cares? I got what I needed from her; get the results in a week. If it comes back negative, I don't know what I'll do. I'm still gluten-free for now.

Michelle in Tn

I do hope the results are conclusive. I think your plan to stay gluten free for now is a good one. Even if it turns out it is not DH there are other skin issues that we sometimes have resolve gluten free. Keep us posted as to the results.