Does Dh Have To Blister?

[JennShad]

Is blistering a necessary characteristic in order for it to be considered DH?....before a biopsy either confirms it or not that is. Mine has never blistered.

[kareng]

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"Can a skin rash be associated with celiac disease?

Dermatitis herpetiformis (DH) is an itchy, blistering skin condition that is a form of celiac disease. The rash usually occurs on the elbows, knees and/or buttocks, and is characterized by its bilateral nature; both knees (and/or both arms) are affected, seldom just one. Many people with DH have no digestive symptoms and only about 40% of them have the positive blood tests (serology) for celiac disease. However, they almost always have the same, gluten-dependent intestinal damage as those with more common symptoms of celiac disease.

DH is diagnosed by a skin biopsy, which involves removing a tiny piece of skin near the rash and testing it for the IgA antibody. DH is treated with a gluten-free diet and medication to control the rash, such as Dapsone or Sulfapyridine. Drug treatment is short term, usually until the gluten-free diet begins to relieve symptoms. It’s not necessary to perform an intestinal biopsy to establish the diagnosis of celiac disease in a patient with DH; the skin biopsy is definitive."

Some pictures from a reliable source:

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[jlaw]

Hi Jenn, my DH comes in many different forms all at once. Some of them are not blisters at all but still definitely DH, so I would say the answer is no.

[squirmingitch]

No, it does not have to blister. Read the entire thread in this link:

[JennShad]

Thank you guys for the input, it's really helpful.

[kareng]

I think that, according to the experts, DH does blister. I posted a couple of medical references about this. It could be possible that after you have been gluten-free, it doesn't come back as strong when glutened.

Here's a few more:

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Open Original Shared Link

[sisterlynr]

DH presents as blisters on me.

[dilettantesteph]

There are other skin conditions associated with celiac disease besides DH: Open Original Shared Link

[sisterlynr]

I saw a new Dermatologist today. This is the 5th one that has looked at my skin to determine what the rash is or is not. He asked if I had blisters (yes) and said he really wished he had seen a blister. I had pictures and described how I used a sterile needle to release the fluid from blisters. That seem to satisfy him that I had blisters even though I have quite an area of rash that the skin has broken and inflamed. Gave me another steroid cream and warned me about infection, told me not to scratch. He asked me, "Does it feel like nettles?" "You ever gotten into a nettle patch?" My reply is "Yes sir."

He wasn't really happy that I was on Dapsone but did take 2 more biopsies NEXT to the lesions on my lower back. He asked if I had had a G6PD test to see if I could tolerate Dapsone. Not had that so he ordered that test. So, not sure without seeing a blister and with being on Dapsone what this biopsy will show but he documented on my record that I had DH.

I told him about the Dermatologist that told me to see a mental/health doctor. He defended him by saying that the skin on my back is thickened from rubbing, scratching and the lesions healing and that is why he would have told me it was neurological in nature. I guess he had to speak up for his associate.