What is worse than an itch?
Well, a lot of things.
But to someone who has a rash that won’t go away, an itch is unbearable, especially if it spreads and refuses to respond to ‘normal’ lotions, ointments, or even steroids.
Let’s examine gluten sensitivity and how it expresses itself in skin disorders, often masquerading as other more common autoimmune dermal problems.
In this 4 part series of posts, let’s start with:
Dermatitis Herpetiformis and Celiac Disease
One of the itches that won’t go away (without proper treatment) is the now-recognised and well-accepted form of gluten sensitivity, dermatitis herpetiformis (DH).
DH was first described as a distinct clinical entity in 1884 by an American dermatologist, Louis Duhring. But it wasn’t until 1967 that is was actually linked to gluten sensitivity.
Typically, DH is characterised by small groups of itchy blisters, often on red plaques, located on the back of the elbows and forearms, on the buttocks and in the front of the knees. But, the rash can occur in other places on the body, including the face, scalp and trunk.
Anyone can get this skin disorder, but its initial outbreak seems to occur more often in younger people.
DH occurs as an immune-system reaction to gluten.
Instead of digesting this protein, the body fights it with an antibody (called IgA) that is produced in the lining of the intestines.
When IgA combines with ingested gluten, the combine antibody/gluten substance circulates in the bloodstream and eventually clogs up the small blood vessels in the skin. The clog attracts white blood cells brought in by the body to fight the invasion. The white blood cells, in turn, release powerful chemicals that create the rash.
The interesting thing about DH is that although it is caused by gluten sensitivity, affected individuals may not have classic signs of gluten intolerance such as distress to the gastrointestinal system. In other words, their gut may not be affected.
That’s why doctors for years did not think to associate the mysterious skin rash, which failed to respond to ‘normal’ protocols, with gluten sensitivity.
If you have DH, you know how bad it is.
One sufferer described that it was “…like rolling in stinging nettles naked with a severe sunburn, then wrapping yourself in a wool blanket filled with ants and fleas….”
Imagine suffering from this type of rash and having it misdiagnosed for years!
That’s what has happened to countless DH sufferers.
In following posts we’ll see a few cases of misdiagnoses;
Best Regards
Paul Smith
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