Does Dermatitis Herpetiformis React Well To Regular Antibiotics?

[QueenEe]

Hi all,

My rash started up after I was gluten free for a few months. First, I got a bumpy, itchy rash on my elbows (both) which cleared up after about a week, without me doing anything to get rid of it. The same rash then appeared on my legs (both) and it hasn't budged since (6+ months)! My GI took one look at it, heard my digestive complaints, and said she was pretty sure it was DH, and that I had celiac. I've never had the intestinal or skin biopsy done to confirm the diagnosis. However, I did notice that once, when I was on a course of antibiotics for strep, my rash cleared up a bit (not all the way, but it did improve). Would this be another indication that it's DH, or does the fact that it reacted well to antibiotics mean that it is something else entirely?

Anyone have any experience with DH and standard antibiotics (not Dapsone) that could advise?

Thanks!

[kareng]

You said that you had strep. If it was a sore throat, could you have been eating gluten-free for a few days? Ice cream, jello, smoothies, etc? It's also possible that some of the sores had some infection to them and the antibiotics helped that.

[pricklypear1971]

I don't have experience with it but there are other meds that can be used. If you google DH treatments you may find a list of alternative rx, match that against your antibiotic.

[lovegrov]

Antibiotics do not get rid of DH.

richard

[pricklypear1971]

  On 4/29/2012 at 4:36 AM, lovegrov said:

Antibiotics do not get rid of DH.

richard

Dapsone is classified as an antibiotic.

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[itchy]

queene: I would interpret your experience differently.

When we are sick our immune systems are preoccupied, and perhaps reduced. DH is an autoimmune reaction so DH is probably reduced when the immune system is diverted.

I have had the experience of my coeliac symptoms being reduced when I was sick. Unfortunately (sic) I haven`t been sick since I stopped eating gluten, so I haven`t been able to check the effect.

I don`t think it was the antibiotics that had an effect, it was the illness.

Background: At least one theory for the rising rates of DH is based on the idea that we no longer have intestinal parasites. Not so long ago a lot of us were harbouring a small zoo of parasites in our guts, and the autoimmune response that causes DH originally evolved to combat these little guests. Without parasites our highly charged immune systems go looking for something else to fight, and for us coeliacs it is gluten. That`s the theory, I don`t know how accepted it is.

Unfortunately the only treatment for DH is gluten avoidance, and even that can take ages to take effect. Certain antibiotics like Dapsone will make the symptoms go away but they do not treat the underlying cause and the symptoms return immmediately when you stop using them.

[squirmingitch]

Along with Dapsone there is sulfapyridine & a couple other antibiotics can be used to treat dh.

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[pricklypear1971]

  On 4/29/2012 at 5:08 PM, itchy said:

queene: I would interpret your experience differently.

When we are sick our immune systems are preoccupied, and perhaps reduced. DH is an autoimmune reaction so DH is probably reduced when the immune system is diverted.

I have had the experience of my coeliac symptoms being reduced when I was sick. Unfortunately (sic) I haven`t been sick since I stopped eating gluten, so I haven`t been able to check the effect.

I don`t think it was the antibiotics that had an effect, it was the illness.

Background: At least one theory for the rising rates of DH is based on the idea that we no longer have intestinal parasites very often any more. Not so long ago a lot of us were harbouring a small zoo of parasites in our guts, and the autoimmune response that causes DH originally evolved to combat these little guests. Without parasites our highly charged immune systems go looking for something else to fight, and for us coeliacs it is gluten. That`s the theory, I don`t know how accepted it is.

Unfortunately the only treatment for DH is gluten avoidance, and even that can take ages to take effect. Certain antibiotics like Dapsone will make the symptoms go away but they do not treat the underlying cause and the symptoms return immmediately when you stop using them.

And sometimes it's the inverse - after the flu my DH flared (when it hadn't flared while gluten-free).

[itchy]

lovegrov, on 28 April 2012 - 08:36 PM, said:

Antibiotics do not get rid of DH.

richard

Prickly pear wrote: Dapsone is classified as an antibiotic.

http://www.drugs.com...petiformis.html

There is a problem of teminology. Whether we think of DH as a disease, or just a symptom of coeliac disease. Clearly Dapsone does not cure or treat the disease of DH, which is coeliac disease in another form.

Dapsone does not treat DH, because those of us with DH must continue to avoid gluten to prevent the underlying effects of the disease on our bodies. However some people are able to use Dapsone to treat the symptoms of DH.

I think it is important to keep the distinction clear.

[lovegrov]

Dapsone, which seems to be more correctly called an anti-bacterial, does indeed treat the symptoms of DH (I took it for 20 years), but it has different action that what most people think of as your standard antibiotic. And, yes, others sulfa drugs have some effect but are generally less effective. You cannot just start popping any old antibiotic (which would be a bad idea anyway) and get rid of your DH symptoms. It simply doesn't work like that.

[ravenwoodglass]

  On 4/29/2012 at 5:08 PM, itchy said:

Background: At least one theory for the rising rates of DH is based on the idea that we no longer have intestinal parasites. Not so long ago a lot of us were harbouring a small zoo of parasites in our guts, and the autoimmune response that causes DH originally evolved to combat these little guests. Without parasites our highly charged immune systems go looking for something else to fight, and for us coeliacs it is gluten. That`s the theory, I don`t know how accepted it is.

DH has been with us for for a long time but for many it is misdiagnosed as something else. I think the rising rates are due to more doctors recognizing it for what it is rather than giving the blanket diagnosis of 'dermatitis' etc.

My mother had it severely beginning in childhood, which for her was in the 1920's. I also had it severely from childhood and it was misdiagnosed as 'poison ivy in my bloodstream'.

Everyone still has 'a small zoo of parasites' in our guts. We couldn't live without them. Personally I do not think this 'theory' is accepted at all.

[itchy]

Actually ravenwood, the actual rates of coeliac have increased dramatically. There was a study, which I don't have time to look up, which compared the rates of antibodies in the current population, to the antibodies in blood stored from the first world war. Coeliac rates are several times higher now, it is not just better identification.

Also, the lovely fauna in our guts that keep us healthy aren't parasites, they are commensals and we probably don't have antibodies to them. The parasites I was talking about are tapeworms, roundworms, etc. which most of us don't want to entertain, but which our ancestors were still putting up with well into the 20th century. Perhaps coincidentally, or perhaps not coincidentally the same time people were finding it easier to get rid of parasites, we were also getting higher rates of coeliac disease.

As you said, there doesn't seem to be proof, but to me it is as good as any other explanation I've heard.