Dermatitis Herpetiformis (DH), a skin disease, is another manifestation of  gluten or wheat allergy. It is characterized by urticarial plaques and blisters on the elbows, buttocks, and knees, although other sites may also be involved. The eruption tends to be persistent: only 10-15% of patients have spontaneous remission over a 25-year study period. The disease is characterized by the presence of IgA deposits in the upper dermis. The HLA-B8 gene is found in 80% of patients with gluten enteropathy and dermatitis herpetiformis.

In DH, clusters of itchy skin bumps, and small blisters appear on the legs, sacrum, buttocks and back - the extensor surfaces of the body. Intense, "dives-me-crazy" itching is typical. As the lesions mature, the skin tends to be red, thickened, bumpy and scratching adds injury to insult. The skin inflammation is typical of a delayed, cell-mediated hypersensitivity reaction. Gluten proteins from ingested wheat  and other grains find their way to the afflicted skin and trigger an immune attack.

The lesions of DH are visible models of how food antigens can bring an inflammatory attack into an organ system and reek havoc. In the skin the inflammation is uncomfortable, but in a more critical organ, the inflammation can have disastrous effects. DH clears completely when all gluten is eliminated from the diet, although healing usually takes several weeks to occur.

Although people with DH and celiac disease often come to their diagnosis by different routes and may not recognize their kinship, both groups are allergic to gluten and have similar risks of developing any or many of the associated diseases. Patients with DH have a high incidence of auto-immune disorders, thyroid disease, pernicious anemia, and insulin-dependent diabetes. As with celiac disease, there is an increased incidence of lymphoma and a gluten-free diet appears to protect patients.

The drugs, Dapsone, sulphapyridine or sulphamethoxypyridazine have been used to suppress the skin manifestation. It takes several months for the skin to improve on these drugs and they do not protect against the serious complication of gluten hypersensitivity. The drugs also have numerous side effects and should not be necessary if treatment begins with a complete food holiday and continues with the Alpha Nutrition Program method of diet design.

The person with DH may not realize that they have major disturbance in their digestive tract but studies have shown similar if not identical disease processes.   T-lymphocytes  in the small intestinal mucosa of celiac disease and dermatitis herpetiformis subjects on a normal diet has been studied and compared to normal controls. The small intestine is a site of vigorous T-cell activity in gluten-sensitive individuals and is consistent with the view that the enteropathy of dermatitis herpetiformis and celiac disease is the result of a delayed-type hypersensitivity  reactions triggered by wheat proteins.

We encourage anyone who has been diagnosed with DH to order the Gluten Rescue Starter Pack  and recover by doing complete diet revision.

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Skin in Health and Disease