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Getting A Biopsy For Possible Dh On Son?

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My two year old has a rash originally diagnosed as eczema that developed when he was six months old with the start of solid food. He has had the rash year round since the age of six months.

I finally ignored the original diagnosis and took him to see a pediatric dermatologist. She considered DH before I even mentioned my recent celiac diagnosis.

Problem is the rash presents like DH, is horribly itchy (he scratches until bleeding) but we don't see fluid filled blisters that could be biopsied. The other night there were a few patches that he had yet to scratch that were small but looked almost like the blisters of poison ivy, small but blister looking. By the next day they were scratched and scabby.

Does there have to be an actual blister for the biopsy?

His celiac panel was negative but his IgA was below normal. So we were told the test was possibly a false negative.

Any thoughts?

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Do have a knowledgeable derm biopsy. It is very important that they know how to biopsy for DH. He needs an active lesions, and it sounds like he has plenty BUT they don't biopsy the lesion the biopsy the area next to the lesion to look for the antibodies. If they biopsy the lesion itself the result will be a false negative.

Here is a article from the NIH's Celiac Awareness Campaign that may be useful

http://www.celiac.nih.gov/Dermatitis.aspx

"A skin biopsy is the key tool in confirming a diagnosis of DH. Doctors take a skin sample from the area next to a lesion and, using a fluorescent dye that highlights antibodies, look for the presence of IgA deposits. Skin biopsies of people with DH are almost always positive for IgA."

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Thank you.

I took him to the dermatologist for a biopsy today. The doctor took a punch of the blister and another punch from the skin about 1/2 an inch away from the blister.

I hope this gives us some answers.

Since he appears to be IgA deficient I was wondering if that would effect the punch biopsy?

Any thoughts?

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Thank you.

I took him to the dermatologist for a biopsy today. The doctor took a punch of the blister and another punch from the skin about 1/2 an inch away from the blister.

I hope this gives us some answers.

Since he appears to be IgA deficient I was wondering if that would effect the punch biopsy?

Any thoughts?

I don't know if the IgA deficiency will make a difference or not. Hopefully you did mention that to the derm, he might know. Do be sure to give the diet a shot after testing is over. It can take a bit of time for DH to totally clear if it is DH but it will clear up.

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