What Does Dermatitis Herpetiformis Look Like?

Dermatitis herpetiformis (DH) or Duhring's disease looks similar to herpes lesion
Dermatitis herpetiformis (DH) or Duhring’s disease looks similar to herpes lesion

Dermatitis herpetiformis (DH) or Duhring’s disease looks similar to herpes lesion (a cluster of dew drops over skin) but is not caused by herpes virus. It is characterized by a cluster of red, itchy, bumpy skin rashes that may affect the elbows, knees, buttocks, lower back, and scalp. The rash can also be confused with eczema or acne.

What is dermatitis herpetiformis?

Dermatitis herpetiformis (DH) is a chronic skin condition caused by gluten sensitivity. Gluten sensitivity means wheat allergy. If we break down the word DH, we get “derm” meaning skin and “itis” meaning inflammation. The blisters look like herpes lesion; hence, the word herpetiformis.

People with DH do not generally exhibit the digestive symptoms commonly seen in patients with celiac disease. 10-25% of people diagnosed with celiac disease have reported DH. 

DH is somewhat more common in men than in women, and men are more likely to have unusual oral or genital rashes.

What causes dermatitis herpetiformis?

The exact cause of dermatitis herpetiformis (DH) is unknown. However, there seems to be a strong link between celiac disease and DH. If you are a gluten-sensitive person and you consume gluten, your immune system of the intestine produces immunoglobulin A (IgA) antibodies. These antibodies travel through the bloodstream and pile up in the blood vessels under the skin. The building up of antibodies triggers the DH rash.

Who are at risk of dermatitis herpetiformis?

People with the following risk factors are at the highest risk of dermatitis herpetiformis (DH):

  • Age between 30 and 40 years
  • Male gender
  • Family history of DH
  • People of European descent
  • Relatives having other autoimmune disorders

What are the symptoms of dermatitis herpetiformis?

The first visible sign of dermatitis herpetiformis (DH) is probably a stinging sensation or burning in certain places on your skin. You may also have symptoms in the skin, mouth, and rarely gastrointestinal tract.

Skin symptoms include:

  • Extremely itchy bumps or blisters, most often on the elbows, knees, back, and buttocks
  • Rashes that are usually the same size and shape on both sides
  • The rash may resemble eczema
  • Scratch marks and skin erosions instead of blisters in some people

Oral symptoms include:

  • Tooth enamel problems
  • Pitting (small depression on the surface of the tooth)
  • Discoloration of teeth
  • Canker sores (ulcer of the mouth)
  • Horizontal grooves (cut or fissure on the teeth)

Gastrointestinal symptoms are not so common in DH. However, if there are any symptoms, it may include:


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How is dermatitis herpetiformis treated?

The physician may prescribe the following treatment regimen for dermatitis herpetiformis (DH):

  • Medications: This may include:
    • Antibiotic: Oral dapsone has proven to get rid of itching and rashes within 1-3 days.
    • Topical corticosteroid cream: Applying corticosteroid cream has been beneficial to relieve itching.
  • Gluten-free diet: Sticking to a gluten-free diet manages your DH by
    • Reducing the necessity for medication to control the skin condition.
    • Reducing the risk of other autoimmune diseases.
    • Reducing the risk of intestinal tumor.
    • Enhancing nutrition and bone density.

The physician may also ask you to avoid iodine to prevent exacerbations of symptoms. It is essential to follow the physician’s advice and treatment for total relief from the disease.

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