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For Testing, What Is An "active Lesion?"

roomorganizing

By roomorganizing
in Dermatitis Herpetiformis

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roomorganizing Rookie
roomorganizing
Posted

Hi, Gang!

About two weeks ago, our daughter showed me a spot on the back of her knee that she said itched really bad. I told her it looked like one of the spots I get on my hands, forearms, and occasionally on my legs and tops of feet. She put a bandaid over it so that she couldn't scratch it and it wouldn't rub on her jeans during school. A few days later, the whole back of her knee was a bright red mess! It looked to me as if it was irritated from the bandaids, but she said it itched. I told her to leave the bandaids off, put shorts on at home, and to put antibiotic cream on the area. It looked somewhat better the next day, but the day after that she showed me other spots that had sprung up down her leg! One on the front side of her knee was like a water blister and she broke it open. Now they all look like open sores and a few of them are the size of nickel or a bit larger. She also has a few spots on her other leg as well.

I took her to our PCP (had to see the PA) on Thursday, and he said it looks like impetigo. He suggested cream and an oral antibiotic. I re-emphasized our family connection to celiac disease (our oldest son, my father with definite dx; my sister, brother, and me with probably celiac disease but no dx) and insisted that I would like to have an updated celiac disease panel run on her as well as a skin biopsy for DH. He was not thrilled, to say the least. He wanted to give it a week of treatment and if it cleared up, all would be good. If not, then we could test for DH. I told him I didn't want to wait a week. They couldn't do the biopsy that day because of scheduling, so we set it up for Tuesday.

My question is: the spots are looking much better, so will the antibiotic treatment cause her to test negative? I read on one post that a steroid treatment would mean a negative result. The spots will definitely still be visible on Tuesday, but does that mean they're "active?" They are no longer draining, but still itch when she touches them. Should I have her discontinue the antibiotic cream and oral?

I am having her eat as much gluten-containing food as possible this weekend. I just don't want this to be a missed opportunity to find the culprit. I know most people go for YEARS without getting the correct dx, just like my dad. Words of wisdom??

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mushroom Proficient
mushroom
Posted

Visible does not mean active, I'm afraid. If they are not driving her crazy they are probably not active :rolleyes: If you want a positive result you should discontinue the AB's, and yes, eat gluten and try to stir things up a bit. You do know it is important that the testing is done on the skin immediately adjacent to a lesion, right? and not on the lesion itself.

roomorganizing Rookie
roomorganizing
Posted
  • Author

Visible does not mean active, I'm afraid. If they are not driving her crazy they are probably not active :rolleyes: If you want a positive result you should discontinue the AB's, and yes, eat gluten and try to stir things up a bit. You do know it is important that the testing is done on the skin immediately adjacent to a lesion, right? and not on the lesion itself.

Thank you, Mushroom! Yes, I do know about the testing site and mentioned it to the PA. He reacted as if he was already aware. If her skin continues to clear and she has no further spots crop up, I may cancel the appointment and wait for another outbreak. No need to make her go through the procedure twice....and I wonder if they would even do another biopsy if the first one comes out negative?? Stopping the antibiotics today!

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