Dermatitis Herpetiformis (DH), a skin disease, is another manifestation of
gluten or wheat allergy. It is characterized by urticarial plaques and blisters
on the elbows, buttocks, and knees, although other sites may also be involved.
The eruption tends to be persistent: only 10-15% of patients have spontaneous
remission over a 25-year study period. The disease is characterized by the
presence of IgA deposits in the upper dermis. The HLA-B8 gene is found in 80% of
patients with gluten enteropathy and dermatitis herpetiformis.
In DH, clusters of itchy skin bumps, and small blisters appear on the legs,
sacrum, buttocks and back - the extensor surfaces of the body. Intense,
"dives-me-crazy" itching is typical. As the lesions mature, the skin tends to be
red, thickened, bumpy and scratching adds injury to insult. The skin
inflammation is typical of a delayed, cell-mediated hypersensitivity reaction.
Gluten proteins from ingested wheat and other grains find their way to the
afflicted skin and trigger an immune attack.
The lesions of DH are visible models of how food antigens can bring an
inflammatory attack into an organ system and reek havoc. In the skin the
inflammation is uncomfortable, but in a more critical organ, the inflammation
can have disastrous effects. DH clears completely when all gluten is eliminated
from the diet, although healing usually takes several weeks to occur.
Although people with DH and celiac disease often come to their diagnosis by
different routes and may not recognize their kinship, both groups are allergic
to gluten and have similar risks of developing any or many of the associated
diseases. Patients with DH have a high incidence of auto-immune disorders,
thyroid disease, pernicious anemia, and insulin-dependent diabetes. As with
celiac disease, there is an increased incidence of lymphoma and a gluten-free
diet appears to protect patients.
The drugs, Dapsone, sulphapyridine or sulphamethoxypyridazine have been used
to suppress the skin manifestation. It takes several months for the skin to
improve on these drugs and they do not protect against the serious complication
of gluten hypersensitivity. The drugs also have numerous side effects and should
not be necessary if treatment begins with a complete food holiday and continues
with the Alpha Nutrition Program method of diet design.
The person with DH may not realize that they have major disturbance in their
digestive tract but studies have shown similar if not identical disease
processes. T-lymphocytes in the small intestinal mucosa of
celiac disease and dermatitis herpetiformis subjects on a normal diet has been
studied and compared to normal controls. The small intestine is a site of
vigorous T-cell activity in gluten-sensitive individuals and is consistent with
the view that the enteropathy of dermatitis herpetiformis and celiac disease is
the result of a delayed-type hypersensitivity reactions triggered by wheat
We encourage anyone who has been diagnosed with DH to order the Gluten Rescue
Starter Pack and recover by doing complete diet revision.