Dermatitis herpetiformis

Dermatitis herpetiformis is a chronic autoimmune skin condition that produces intensely itchy clusters of bumps and blisters, and it is regarded as a skin manifestation of coeliac disease. It mainly affects adults, is reported more often in men, and sometimes occurs in children. The exact cause is unknown; an abnormal immune response to gluten leads to antibody deposits in the skin, and the rash has no connection with the herpes virus. The rash usually appears symmetrically over the elbows, knees, buttocks, back or scalp, and scratching often leaves erosions instead of intact blisters; only some patients have bowel symptoms. A skin biopsy with direct immunofluorescence confirms the diagnosis, supported by blood tests for antibodies. Dapsone, an antibiotic, controls symptoms effectively, while a strict gluten-free diet is the sole treatment aimed at the underlying disorder, so management is long-term. Possible complications include autoimmune thyroid disease and intestinal lymphoma.

Seek urgent care for a rapidly spreading rash with fever, a rash with blisters or peeling, or facial swelling. See a doctor for skin changes that do not improve with over-the-counter treatment after a few weeks, a mole that changes, or acne that is scarring or affecting your confidence. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.