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Health Condition

Dermatitis Herpetiformis

About This Condition

Dermatitis herpetiformis (DH) is a chronic disease of the skin that may occur in people of any age, but is most common in the second to fourth decades of life.1

Symptoms

DH is characterized by intensely itchy hives or blister-like patches of skin located primarily on elbows, knees, and buttocks, although other sites may be involved. A burning or stinging sensation may accompany the itching.

Other Therapies

Strict adherence to a gluten-free diet is essential.

References

1. Gawkrodger DJ, Blackwell JN, Gilmour HM, et al. Dermatitis herpetiformis: diagnosis, diet and demography. Gut 1984;25:151-7.

2. Juhlin L, Edqvist LE, Ekman LG, et al. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol 1982;62:211-4.

3. Ljunghall K, Juhlin L, Edqvist LE, Plantin LO. Selenium, glutathione-peroxidase and dermatitis herpetiformis. Acta Derm Venereol 1984;64:546-7.

4. Juhlin L, Edqvist LE, Ekman LG, et al. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol 1982;62:211-4.

5. Ljunghall K, Juhlin L, Edqvist LE, Plantin LO. Selenium, glutathione-peroxidase and dermatitis herpetiformis. Acta Derm Venereol 1984;64:546-7.

6. Yancy KB, Lawley TJ. “Immunologically Mediated Skin Diseases.”Harrison's Online. 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Jan 10, 2000).

7. Kastrup W, Mobacken H, Stockbrugger R, et al. Malabsorption of vitamin B12 in dermatitis herpetiformis and its association with pernicious anaemia. Acta Med Scand 1986;220:261-8.

8. Gawkrodger DJ, Ferguson A, Barnetson RS. Nutritional status in patients with dermatitis herpetiformis. Am J Clin Nutr 1988;48:355-60.

9. Hoffbrand AV, Douglas AP, Fry L, Stewart JS. Malabsorption of dietary folate (Pteroylpolyglutamates) in adult coeliac disease and dermatitis herpetiformis. Br Med J 1970;4:85-9.

10. Davies MG, Marks R, Nuki G. Dermatitis herpetiformis—a skin manifestation of a generalized disturbance in immunity. Q J Med 1978;47:221-48.

11. Crofton RW, Glover SC, Ewen SWB, et al. Zinc absorption in celiac disease and dermatitis herpetiformis: a test of small intestinal function. Am J Clin Nutr 1983;38:706-12.

12. Di Stefano M, Jorizzo RA, Veneto G, et al. Bone mass and metabolism in dermatitis herpetiformis. Dig Dis Sci 1999;44:2139-43.

13. Yancy KB, Lawley TJ. “Immunologically Mediated Skin Diseases.”Harrison's Online. 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Jan 10, 2000).

14. Kastrup W, Mobacken H, Stockbrugger R, et al. Malabsorption of vitamin B12 in dermatitis herpetiformis and its association with pernicious anaemia. Acta Med Scand 1986;220:261-8.

15. Gawkrodger DJ, Ferguson A, Barnetson RS. Nutritional status in patients with dermatitis herpetiformis. Am J Clin Nutr 1988;48:355-60.

16. Hoffbrand AV, Douglas AP, Fry L, Stewart JS. Malabsorption of dietary folate (Pteroylpolyglutamates) in adult coeliac disease and dermatitis herpetiformis. Br Med J 1970;4:85-9.

17. Davies MG, Marks R, Nuki G. Dermatitis herpetiformis—a skin manifestation of a generalized disturbance in immunity. Q J Med 1978;47:221-48.

18. Crofton RW, Glover SC, Ewen SWB, et al. Zinc absorption in celiac disease and dermatitis herpetiformis: a test of small intestinal function. Am J Clin Nutr 1983;38:706-12.

19. Di Stefano M, Jorizzo RA, Veneto G, et al. Bone mass and metabolism in dermatitis herpetiformis. Dig Dis Sci 1999;44:2139-43.

20. Yancy KB, Lawley TJ. “Immunologically Mediated Skin Diseases.”Harrison's Online. 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Jan 10, 2000).

21. Kastrup W, Mobacken H, Stockbrugger R, et al. Malabsorption of vitamin B12 in dermatitis herpetiformis and its association with pernicious anaemia. Acta Med Scand 1986;220:261-8.

22. Gawkrodger DJ, Ferguson A, Barnetson RS. Nutritional status in patients with dermatitis herpetiformis. Am J Clin Nutr 1988;48:355-60.

23. Hoffbrand AV, Douglas AP, Fry L, Stewart JS. Malabsorption of dietary folate (Pteroylpolyglutamates) in adult coeliac disease and dermatitis herpetiformis. Br Med J 1970;4:85-9.

24. Davies MG, Marks R, Nuki G. Dermatitis herpetiformis—a skin manifestation of a generalized disturbance in immunity. Q J Med 1978;47:221-48.

25. Crofton RW, Glover SC, Ewen SWB, et al. Zinc absorption in celiac disease and dermatitis herpetiformis: a test of small intestinal function. Am J Clin Nutr 1983;38:706-12.

26. Di Stefano M, Jorizzo RA, Veneto G, et al. Bone mass and metabolism in dermatitis herpetiformis. Dig Dis Sci 1999;44:2139-43.

27. Zarafonetis CJ, Johnwick EB, Kirkman LW, Curtis AC. Paraaminobenzoic acid in dermatitis herpetiformis. Arch Dermatol Syph 1951;63:115-32.

28. Yancy KB, Lawley TJ. “Immunologically Mediated Skin Diseases.”Harrison's Online. 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Jan 10, 2000).

29. Kastrup W, Mobacken H, Stockbrugger R, et al. Malabsorption of vitamin B12 in dermatitis herpetiformis and its association with pernicious anaemia. Acta Med Scand 1986;220:261-8.

30. Gawkrodger DJ, Ferguson A, Barnetson RS. Nutritional status in patients with dermatitis herpetiformis. Am J Clin Nutr 1988;48:355-60.

31. Hoffbrand AV, Douglas AP, Fry L, Stewart JS. Malabsorption of dietary folate (Pteroylpolyglutamates) in adult coeliac disease and dermatitis herpetiformis. Br Med J 1970;4:85-9.

32. Davies MG, Marks R, Nuki G. Dermatitis herpetiformis—a skin manifestation of a generalized disturbance in immunity. Q J Med 1978;47:221-48.

33. Crofton RW, Glover SC, Ewen SWB, et al. Zinc absorption in celiac disease and dermatitis herpetiformis: a test of small intestinal function. Am J Clin Nutr 1983;38:706-12.

34. Di Stefano M, Jorizzo RA, Veneto G, et al. Bone mass and metabolism in dermatitis herpetiformis. Dig Dis Sci 1999;44:2139-43.

35. Otley C, Hall RP. Dermatitis herpetiformis. Dermatol Clin 1990;8:759-69 [review].

36. Reunala T, Kosnai I, Karpati S, et al. Dermatitis herpetiformis: jejunal findings and skin response to gluten free diet. Arch Dis Child 1984;59:517-22.

37. Hall RP. Dietary management of dermatitis herpetiformis. Arch Dermatol 1987;123:1378a-80a.

38. Ferguson A, Blackwell JN, Barnetson RS. Effects of additional dietary gluten on the small-intestinal mucosa of volunteers and of patients with dermatitis herpetiformis. Scand J Gastroenterol 1987;22:543-9.

39. Yancy KB, Lawley TJ. “Immunologically Mediated Skin Diseases.”Harrison's Online. 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Jan 10, 2000).

40. Fry L. Dermatitis herpetiformis. Baillieres Clin Gastroenterol 1995;9:371-93 [review].

41. Garioch JJ, Lewis HM, Sargent SA, et al. 25 years' experience of a gluten-free diet in the treatment of dermatitis herpetiformis. Br J Dermatol 1994;131:541-5.

42. Chorzelski TP, Rosinska D, Beutner E, et al. Aggressive gluten challenge of dermatitis herpetiformis cases converts them from seronegative to seropositive for IgA-class endomysial antibodies. J Am Acad Dermatol 1988;18:672-8.

43. Kosnai I, Karpati S, Savilahti E, et al. Gluten challenge in children with dermatitis herpetiformis: a clinical, morphological and immunohistological study. Gut 1986;27:1464-70.

44. Ermacora E, Prampolini L, Tribbia G, et al. Long-term follow-up of dermatitis herpetiformis in children. J Am Acad Dermatol 1986;15:24-30.

45. Frodin T, Gotthard R, Hed J, et al. Gluten-free diet for dermatitis herpetiformis: the long-term effect on cutaneous, immunological and jejunal manifestations. Acta Derm Venereol 1981;61:405-11.

46. Fry L, Leonard JN, Swain F, et al. Long term follow-up of dermatitis herpetiformis with and without dietary gluten withdrawal. Br J Dermatol 1982;107:631-40.

47. Collin P, Pukkala E, Reunala T. Malignancy and survival in dermatitis herpetiformis: a comparison with coeliac disease. Gut 1996;38:528-30.

48. Leonard JN, Tucker WF, Fry JS, et al. Increased incidence of malignancy in dermatitis herpetiformis. Br Med J (Clin Res Ed) 1983;286:16-8.

49. Reunala T, Helin H, Kuokkanen K, Hakala T. Lymphoma in dermatitis herpetiformis: report on four cases. Acta Derm Venereol 1982;62:343-6.

50. Reunala T, Collin P. Diseases associated with dermatitis herpetiformis. Br J Dermatol 1997;136:315-8.

51. Christensen OB, Hindsen M, Svensson A. Natural history of dermatitis herpetiformis in southern Sweden. Dermatologica 1986;173:271-7.

52. Lewis HM, Renaula TL, Garioch JJ, et al. Protective effect of gluten-free diet against development of lymphoma in dermatitis herpetiformis. Br J Dermatol 1996;135:363-7.

53. Kadunce DP, McMurry MP, Avots-Avotins A, et al. The effect of an elemental diet with and without gluten on disease activity in dermatitis herpetiformis. J Invest Dermatol 1991;97:175-82.

54. van der Meer JB, Zeedijk N, Poen H, van der Putte SC. Rapid improvement of dermatitis herpetiformis after elemental diet. Arch Dermatol Res 1981;271:455-9.

55. Zeedijk N, van der Meer JB, Poen H, van der Putte SC. Dermatitis herpetiformis: consequences of elemental diet. Acta Derm Venereol 1986;66:316-20.

56. Engquist A, Pock-Steen OC. Dermatitis herpetiformis and milk-free diet. Lancet 1971;2:438-9.

57. Pock-Steen OC, Niordson AM. Milk sensitivity in dermatitis herpetiformis. Br J Dermatol 1970;83:614-9.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.