dermatitis herpetiformis

[Guest guest]

I did some reading on dermatitis herpetiformis (DH) , a skin

condition associated with often asymptomatic gluten-sensitive

enteropathy (celiac disease). Although theoretically appealing, I

don't see an easy relationship between it and rosacea, based on its

appearance (herpes-like blisters, crusting, plaques and papules),

presentation (although it can appear anywhere, it's most commonly on

extensor surfaces -- the surfaces of the arms and legs when extended,

rather than flexed -- less commonly on the buttocks, shoulders, and

the posterior (nuchal) scalp) and symptoms (intense itching and

burning; nothing about erythema/telangectiasis or papular/pustular).

Biopsy will usually clinch the diagnosis (much different than

rosacean skin biopsies), and treatment is dietary control of gluten

+/- dapsone. It's very interesting that, like rosacea, DH is treated

with an antibiotic thought to work as an anti-inflammatory (although

dapsone is hardly safe, like the ones we use for rosacea).

DH/Celiac disease is associated with auto-immune disorders; it would

be interesting to see if Celiac Disease and rosacea are associated.

I don't believe, from what I'm reading, that it's likely rosacea

would be misdiagnosed as DH.

Nothing much from a Medline search either.

Here's a reference to those who want more information, including a

good picture at the end of the chapter:

http://www.emedicine.com/DERM/topic95.htm

Hope that helps. Let me know if there's anything I'm missing.

Marjorie

Marjorie Lazoff, MD