<<Disclaimer: Verify this information before applying it to your situation.>>

I received nearly 30 replies to my query regarding DH on the scalp. All
were much appreciated and helpful - most felt that the description was
similar to their experience, and most found that their rash vanished
with the gf diet (with the exception of one person who still takes 25 mg
Dapsone daily even after 5 years of strict gf living). One did not think
it sounded at all like DH, yet went on to give a description that fit
exactly what I see on this scalp, with the exception that I would not
call the rash symmetrical. No one responded re the wisdom of CD testing
(I figured that if all DH have CD, then CD testing might be a better
route to take, since the DH testing involves a biopsy by a competent
doctor and then also a competent lab to read the results). However, as I
posted separately the availability of a comprehensive celiac disease
system test from Prometheus laboratories would seem to fit the bill for
this situation. I opted not to wait on the test results, but will indeed
post to the list when all of that is finally completed.

Below is a good description of DH, but I hasten to add that many felt
that theirs was not necessarily "typical"; most were misdiagnosed with
psoriasis and eczema (and some got worse with cortisone); some found a
certain amount of relief with very long hot rinses after shampooing;
others with special shampoos and conditioners bought on-line (Abaka
shampoo from Abaka Republic); others found some relief with the shampoo
Sebulex; very interestingly, one person mentioned that relief only came
after working with a naturopath who recommended various nutritional
changes (avoiding egg, dairy, soy), treated for systemic Candida, and
provided mega dose IV vitamins which was what lead to healing almost
overnight - complete recovery after the second treatment one week later.
This is intuitively very appealing, as particularly an undiagnosed CD
patient would likely be having some malabsorption which would aggravate
skin problems; additionally there's the low acid issue for those whose
GERD is treated with PPIs and acid reducers.

Finally, one person sent links to google images for psoriasis, which can
be caused by gluten as well. Psoriasis patients with antibodies to
gliadin can be improved by a gluten free diet. What a shame that so many
psoriasis sufferers are not aware of this (I know one who steadfastly
refuses the CD testing as they believe that they have already been
tested "for everything"...). Once a rash has been scratched, it can be
pretty hard to distinguish one from the other, but I would say that
indeed this could be psoriasis or DH, and am hopeful that the Prometheus
testing will lead to the gf diet (I think it should be tried regardless
of the results, but if the results are positive, it will be easier to
take the diet seriously). Thanks to all who responded - I tried to reply
to most, but all were appreciated.
Hilary


From: "Don Wiss"

DH is a burning stinging itch symmetrically distributed.

A new unscratched lesion is red, raised, and usually less than 1 cm in
diameter with a tiny clear blister at the center. However, if scratched,
crusting appears on the surface. The "burning" or "stinging" sensation
is different from a "regular" itch, and can often occur 8-12 hours
before a lesion appears. One patient described the itch "...like rolling
in poison ivy naked with a severe sunburn, then wrapping yourself in a
wool blanket filled with ants and fleas."

The most common areas are the extensor surfaces of the elbows and knees,
back of the neck and scalp, upper back (shoulders), the buttocks,
sacrum, and face. Facial and hair-line lesions are not uncommon; the
inside of the mouth is rarely affected. The rash has symmetric
distribution.

Several physical triggers are known to set off an attack of DH,
especially exposure to iodides and bromides which are contained in
household cleaners. Other triggers of an attack are sunlight and
pre-menstrual hormones. Ibuprofen (NSAIDs) types of pain relievers may
increase DH problems. Also consumption of large quantities of iodides
(some iodine is needed in the diet), kelp, shellfish, non-steroidal
anti-inflammatory agents (such as aspirin), gluten, and stress.

What else looks like DH? (1) DH can be misdiagnosed as psoriasis, or the
patient may have both conditions. (2) Linear IgA disease--the
immunofluorescence pattern is different, but it looks and feels the same
as DH to the patient. (3) Allergic contact reactions.

For images of severe cases see:

    http://www.GFlinks.com/#DH

I can send you a detailed file on this, if this description fits the rash.

Don.

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