<<Disclaimer: Verify this information before applying it to your situation.>>
 
There has been some talk recently of using a skin biopsy to diagnose
celiac disease (CD).  I'd like to share some concerns I have with this
process.  First I'll point out that I am not a medical professional,
just a layperson with two celiac children.  With that caveat, let me
continue.
 
Only a small percentage of celiacs have dermatitis herpetiformis (DH).
If you have a biopsy done on a skin lesion and it comes back positive,
then you have a diagnosis of DH and therefore (according to some GIs)
you also have a diagnosis of CD.  Case closed; begin GF diet for life.
This scenario is probably okay.
 
But what if the skin biopsy comes back negative?  Can you safely
conclude that you don't have CD?  In my opinion, the answer is a
resounding NO.  All you've proven is that you don't have DH, which
is true of most celiacs anyway.  It is quite possible to have CD and
some other sort of skin affliction.  In this case the skin biopsy
could be doing you a real disservice by giving you a false impression
regarding CD.
 
I believe that the small intestine biopsy is still considered the
"gold standard" for diagnosing CD.  Blood tests, skin biopsies, and
improved symptoms on a trial GF diet can all be suggestive of CD; but
the only way to be certain of a CD diagnosis is a small intestine
biopsy after a prolonged period on a gluten-containing diet.
 
Remember, these are the prattlings of a layperson.
 
Jim Lyles ........ <[log in to unmask]> ........ Holly, Michigan, USA