Does eating gluten cause severe, itchy skin blisters? Let's learn about Dermatitis Herpetiformis!

Have you ever eaten something like bread, cake, or biscuits and then a few hours later, you started to get these itchy, watery bumps on your body? Sometimes, the itching can be so severe that you can't sleep at night. While many people think that this is just a common allergy, it may be something that needs to be thought about a little deeper. Today, we're going to talk about this skin condition that many people don't know about, but can affect many people. That's Dermatitis Herpetiformis.

Simply put, what is Dermatitis Herpetiformis?

Dermatitis Herpetiformis is a chronic skin condition. The main cause of this is your body's sensitivity to a protein called gluten. Gluten is a substance found in grains like wheat, rye, and barley. So, many of the foods we eat every day, such as bread, pasta, cakes, and biscuits, contain gluten.

When you eat a food that contains gluten, your body's immune system reacts to it. This response results in blisters and red spots on your skin that itch excessively.

Often, people with Dermatitis Herpetiformis also have a condition called Celiac disease. But surprisingly, they may not have the symptoms of celiac disease, such as abdominal pain, diarrhea, or weight loss. That's why this condition is sometimes called the "skin manifestation of celiac disease." However, very rarely, it is possible to have Dermatitis Herpetiformis without having celiac disease.

Does this have anything to do with the herpes virus?

When hearing this name, many people may think that this is a disease caused by the herpes virus. No, not at all. This disease has nothing to do with the herpes virus.

The word "dermatitis" comes from the words "derm" meaning "skin" and "itis" meaning "inflammation." It means "inflammation of the skin." The word "herpetiformis" comes from the fact that the blisters that form in this condition are similar in appearance to those of herpes. Other than that, there is no other connection between the two. So don't be alarmed by the name.

Who is affected the most by this situation?

Dermatitis Herpetiformis can affect anyone of any age. However, some people are at higher risk of developing it. See if you fall into one of these groups.

• People between the ages of 30 and 40 .
• People with Celiac disease (About 10% - 25% of people with Dermatitis Herpetiformis also have Celiac disease.)
• If anyone in the family (especially close relatives like mother, father, siblings) has Dermatitis Herpetiformis or Celiac Disease.
• If there is a family history of other autoimmune conditions . For example, thyroid disease, vitiligo, type 1 diabetes, anemia, etc.
• Men have a slightly higher tendency than women.
• It is most common in people of Northern European descent.

What are the main symptoms of this disease?

These symptoms may vary from person to person, but there are some common symptoms. Let's look at the table below to understand this clearly.

Where do these blisters appear most often?

Although these blisters can appear anywhere on the body, they are most often seen symmetrically on both sides of the body. That is, if they appear on the right knee, they are likely to appear on the left knee as well.

• Knees
• Elbows
• Buttocks
• Scalp and Hairline
• Upper back

Why is this happening? What is the reason?

The reason is very simple. This is an autoimmune reaction.

Imagine, you eat a food containing gluten. When it is digested, your body's immune system mistakes this gluten as an "enemy." It then produces a special type of antibody called IgA to fight against this "enemy."

Normally, these antibodies should be present in the blood. But in this case, these IgA antibodies go and get deposited in the small blood vessels of your skin. When they get deposited like this, another immune reaction occurs in those areas, which is what causes that severe itching and blistering.

There is also a genetic influence. In particular, people who carry the genes HLA-DQ2 and HLA-DQ8 are at increased risk of developing Dermatitis Herpetiformis and Celiac Disease.

How does a doctor diagnose this exactly?

If you have these symptoms, the best thing to do is to see a doctor right away. It's best to see a dermatologist, a doctor who specializes in skin diseases. The doctor will examine your skin and may then run a few tests to confirm the diagnosis.

1. Skin Biopsy: This is the best way to confirm the disease. A very small piece of healthy skin is taken from near the blister and examined under a microscope. This can then be used to determine if the IgA antibodies we talked about earlier are present.

2. Blood Test: Your blood is tested for antibodies (anti-endomysial and anti-tissue transglutaminase) that are associated with celiac disease. If these antibodies are present and the skin biopsy is positive, there is a high chance that you also have celiac disease.

These tests are the only way to accurately determine whether it is Dermatitis Herpetiformis or another skin condition such as eczema or scabies.

What are the treatments for this?

There are two main ways to treat this. The most effective method is to use both of them together.

1. Gluten-Free Diet

This is the long-term and most important treatment . Because your body is reacting to gluten, if you stop eating gluten completely, these symptoms will stop appearing after a while.

Key foods to avoid:

• Everything made from wheat flour (bread, buns, cakes, biscuits, pasta, noodles)
• Barley
• Rye
• Some sauces, cereals, and processed meats may also contain gluten, so read the label carefully when buying anything from the store.

This diet may take some time to get used to, but it's very important for your skin health and to prevent damage from celiac disease if you have it.

2. Medication

It can take several months, maybe a year, to see results from a gluten-free diet. But it's hard to endure that long with that intense itching. So, your doctor will prescribe you a medication to quickly control the itching and blisters.

The most commonly prescribed medication is Dapsone . This medication can significantly reduce itching and inflammation within 24-48 hours. However, it is not a cure, it only controls symptoms. If you do not stop eating gluten, symptoms will return once you stop taking the medication.

When you take dapsone, your doctor will regularly check your blood, as it can cause some side effects. Therefore, it is essential to take the medication and have the tests exactly as your doctor tells you.

How to live with this situation?

Dermatitis Herpetiformis is a lifelong condition. This means that it cannot be completely cured. But it can be well controlled .

If you follow a strict gluten-free diet, you can live a normal life without any symptoms. Sometimes, you can go into remission for years. But it's important to continue the gluten-free diet during that time.

This itching can interfere with daily activities and sleep. The blisters on the skin can make it difficult to face society. But remember, this is not your fault. All this can be avoided with proper treatment and diet. If you are uncomfortable, talk to your doctor about it.

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