Dermatitis herpetiformis (DH)

 

Overview

Chronic skin rashes of bumps and blisters. The cause remains unknown, but genetics, gluten sensitivity, and other autoimmune diseases are believed to play a role. Some suspect that this is caused by deposits of immunoglobulin A (IgA) in the skin, which triggers additional immunologic reactions that form lesions. Typically DH is regarded as a manifestation of celiac disease, but less than 20% will have any of the other symptoms of celiac disease.

Common Symptoms

Off-and-on skin rashes, blisters, skin darkening or bumps, itching, and redness may be apparent, particularly along the elbows, knees, buttocks, and scalp. Tooth enamel can also develop horizontal grooves or discoloration in patients that also have celiac disease.

Coexisting Diseases and Conditions

DH can present as a skin manifestation of celiac disease. It is mostly seen in adult patients with celiac disease, with the average onset occurring between 30-40 years of age. It resolves itself with the removal of gluten from the diet, and typically only flares upon gluten ingestion. It is rare in children, so any rashes are typically ascribed (correctly) to a different cause. This article, published in the peer-reviewed journal Nutrients, details a review of skin conditions seen in children with celiac disease, including DH.
Other coexisting diseases and conditions include linear IgA disease, pemphigoid, eczema, hyperthyroidism, and scabies.

Risk Factors and Prevalence

Sources

  1. Article Sources
    1. Dermatitis Herpetiformis. (n.d.). NORD (National Organization for Rare Disorders). Retrieved July 12, 2021, from https://rarediseases.org/rare-diseases/dermatitis-herpetiformis/

    2. Dermatitis Herpetiformis | NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved July 12, 2021, from https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/digestive-diseases/dermatitis-herpetiformis