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Do You Need An Intact Blister?

dilettantesteph

By dilettantesteph
in Dermatitis Herpetiformis

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dilettantesteph Collaborator
dilettantesteph
Posted

I thought that the biopsy was supposed to be adjacent to a blister. Why should it matter whether or not the blister is intact? It is really hard not to scratch so that it stays intact. Plus, the doctor said that it is the blister which is biopsied until I said that I thought it was next to the blister where you were supposed to biopsy. Does she know what she is doing?

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jerseyangel Proficient
jerseyangel
Posted

I thought that the biopsy was supposed to be adjacent to a blister. Why should it matter whether or not the blister is intact? It is really hard not to scratch so that it stays intact. Plus, the doctor said that it is the blister which is biopsied until I said that I thought it was next to the blister where you were supposed to biopsy. Does she know what she is doing?

The doctor is wrong, Steph--the biopsy needs to be done on skin adjacent to the blister, not the blister itself.

kareng Grand Master
kareng
Posted

Trying showing the derm this from the Univ of Chicago Celiac Center.

Open Original Shared Link

dilettantesteph Collaborator
dilettantesteph
Posted
  • Author

Is it possible that you need an intact blister even if you biopsy next to it? It is this doctor or wait until I move to a new area. She is one of those doctors who already knows everything and is unwilling to listen. When asked a question she didn't know she just answered with a bunch of stuff she did know.

Hopeful1950 Explorer
Hopeful1950
Posted

The blisters of DH tend to be fragile and I have rarely seen one for the reasons you have described. I feel the itch and rub or scratch and they're gone. All she needs is an active lesion to biopsy next to. You'll have to point her to the active lesion if she needs a blister to find it....ha, ha. She made need a blister to biopsy for other things, but not for DH. If she biopsies on a blister/lesion, she won't find any antibodies because they will be gone. Be persistent and take your medical research with you to show her. I hope she will be receptive.

mushroom Proficient
mushroom
Posted

I could not find anything that requires the blister to be intact.

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Diagnosis is through immunofluorescence staining on a skin biopsy taken near a group of blisters, not from the blister itself. In patients with DH, the test will show IgA antibodies in the skin. Open Original Shared Link

dilettantesteph Collaborator
dilettantesteph
Posted
  • Author

Shoot. She is supposed to be the best in the area. I knew it wasn't looking good when she recommended oatmeal baths.

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mushroom Proficient
mushroom
Posted

Shoot. She is supposed to be the best in the area. I knew it wasn't looking good when she recommended oatmeal baths.

:unsure:

:(

eatmeat4good Enthusiast
eatmeat4good
Posted

I've never seen an intact blister either.

That's part of the reason it went undiagnosed for so long.

Definitely not blistered looking.

They rub off or scratch off as soon as they form.

I hope you get a result, but if not, you can be gluten free anyway.

I couldn't believe how bad the iodine reation was.

I hope you heal fast.

dilettantesteph Collaborator
dilettantesteph
Posted
  • Author

I hope you get a result, but if not, you can be gluten free anyway.

I couldn't believe how bad the iodine reation was.

I hope you heal fast.

I've been gluten free for over 3 years. The biopsy was just for conformation, which it looks like I won't be getting any time soon. Tell me about the iodine reaction.

eatmeat4good Enthusiast
eatmeat4good
Posted

It was just as if I had eaten gluten. Sores that had healed reopened. Some filled with fluid and hurt hurt hurt.

Itch, burn, sting, hurt.

It has taken me two weeks to get them healed after eating crawfish.

Shellfish have iodine. Also table salt. If your antibodies are still in the skin you can have a very bad reaction.

Iodine reactivates the antibodies.

I'm starting Dapsone because I am soooo sensitive to iodine now with no end in sight.

The antibodies remain in your skin for up to 10 years and the sores can take up to 6 months to 2 years to heal.

dilettantesteph Collaborator
dilettantesteph
Posted
  • Author

It was just as if I had eaten gluten. Sores that had healed reopened. Some filled with fluid and hurt hurt hurt.

Itch, burn, sting, hurt.

It has taken me two weeks to get them healed after eating crawfish.

Shellfish have iodine. Also table salt. If your antibodies are still in the skin you can have a very bad reaction.

Iodine reactivates the antibodies.

I'm starting Dapsone because I am soooo sensitive to iodine now with no end in sight.

The antibodies remain in your skin for up to 10 years and the sores can take up to 6 months to 2 years to heal.

I am sorry that you have been suffering like that. How long have you been gluten free?

eatmeat4good Enthusiast
eatmeat4good
Posted

Only 4 months.

Just started taking Dapsone.

Seems to be working well.

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