Dermatitis herpetiformis is a gluten induced extremely itchy and blistering rash. About 25% of patients with celiac disease and Hashimoto’s thyroiditis have dermatitis herpetiformis. The blisters appear on the elbows, knees, face, scalp, trunk, buttocks and occasionally within the mouth. The lesions are symmetrically diffused and are slow to heal.
The predominant symptoms are itching and burning that is rapidly relieved when the blisters rupture. This disease is usually found in patients 30 to 40 years old. It rarely occurs in African Americans and Asians.
Diagnosis of dermatitis herpetiformis could be confirmed through testing:
- skin biopsy taken from uninvolved skin. An irregular layer of IgA antibody deposits could be detected using immunofluorescence analysis.
The immune system responds to gluten as an antigen and builds antibodies against these proteins. Gluen can cause the disease and trigger an autoimmune response.
Dermatitis herpetiformis, celiac and Hashimoto’s diseases have a lot of in common:
- share the same genetic background HLA-DQ2 and/or HLA-DQ8
- triggered by an autoimmune response to gluten
- associated with other autoimmune conditions such as Hashimoto’s thyroiditis that is found in as many as 1 in 4 dermatitis herpetiformis patients
- contribute to the development of other autoimmune conditions. If untreated both celiac disease and dermatitis herpetiformis carry an increased risk of lymphomas which is cancer in the lymphatic cells of the immune system.
However, there are some differences in the expression of celiac disease and dermatitis herpetiformis:
- signs and symptoms of malabsorption in dermatitis herpetiformis are usually absent or minor
- celiac disease is prevalent in female, dermatitis herpetiformis in male
- there is no association between the intensity of the intestinal damage found in a biopsy or the intensity of the skin lesions in dermatitis herpetiformis.
Dapson is a drug for treatment of dermatitis herpetiformis. The drug suppresses the disease and itching usually stops 2 or 3 hours after ingestion. However, the drug does not cure the disease and is completely ineffective for the treatment of intestinal lesions.
A gluten free diet is considered to be the best treatment for celiac disease and dermatitis herpetiformis resulting in clearing the skin and intestinal damage. However, it can take a long time for the lesions to clear. When gluten is reintroduced into the diet the symptoms appear again within weeks.
A gluten-free diet is a life time requirement for individuals with dermatitis herpetiformis conditions. Patients with autoimmune conditions and Hashimoto’s disease may benefit from the gluten-free diet due to reducing inflammation and thyroid antibodies activity. The Gluten-free food list, Gluten containing food list and “Hidden” sources of gluten in the Resources section could help you to make right food choices.
Some people develop food allergies as adults. The majority has skin rash, itching and get hives. If dermatitis herpetiformis, celiac disease and/or adult food allergies are diagnosed in people with Hashimoto’s it can be an indicator that a person developed a leaky gut syndrome. The integrity of the intestine is compromised but may still do not show up on the standard blood tests. Advanced holistic testing can help to identify and properly diagnose this health conditions.
It is very important to heal the intestinal damage to improve with Hashimoto’s and calm down the overreaction of the immune system. In this case using GAPS diet that supports healing can bring more benefits as going on the gluten-free diet alone where you only remove gluten as a trigger of the disease.
Holistic approaches can help to heal leaky gut and associated skin rash:
- Leaky gut cure program by Dr. Karen Brimeyer that guides you step-by-step through the healing process
- GAPS diet that was created by Dr. Natasha Campbell-McBride to heal the digestive system and restore intestinal lining barrier in people with digestive and immune system disorder.
P.S. There is a lot more to discover about Hashimoto’s thyroiditis, so sign up for Outsmart Disease blog updates and get FREE e-mail course Nutritional guide for Hashimoto’s disease to learn more.
References:
Celiac disease: guide to living with gluten intolerance. Sylvia Llewelyn Bower, Mary Kay Sharrett, Steve Plogsted. Demos Medical Publishing, 2006
My name is Marina Gutner, PhD. I am a researcher, medical writer, Author of forthcoming series on thyroid, hypothyroidism and autoimmune disease. I was diagnosed with autoimmune Hashimoto’s disease and hypothyroidism in 2004 and soon got so sick that I was unable to function. It took me years of research to find how to recover from severe adrenal insufficiency, stop Hashimoto’s and reduce my high dose of thyroid medication. On my blog I show you exactly how I did it so you can learn how to get started. Read more in 
