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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Dermatitis herpetiformis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Dermatitis herpetiformis (DH) is a very itchy rash consisting of bumps and <a test="test" href="./003939.htm">blisters</a>. The rash is chronic (long-term).</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>DH usually begins in people age 20 and older. Children can sometimes be affected. It is seen in both men and women.</p><p>The exact cause is unknown. Despite the name, it is not related to the herpes virus. DH is an <a test="test" href="./000816.htm">autoimmune disorder</a>. There is a strong link between DH and <a test="test" href="./000233.htm">celiac disease</a>. Celiac disease is an autoimmune disorder that causes inflammation in the small intestine from eating gluten. People with DH also have a sensitivity to gluten, which causes the skin rash. About 25% of people with celiac disease also have DH.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms include:</p><ul><li>Extremely itchy bumps or blisters, most often on the elbows, knees, back, and buttocks.</li><li>Rashes that are usually the same size and shape on both sides.</li><li>The rash can look like <a test="test" href="./000853.htm">eczema</a>.</li><li>Scratch marks and skin erosions instead of blisters in some people.</li></ul><p>Most people with DH have damage to their intestines from eating gluten. But only some have intestinal symptoms.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>In most cases, a <a test="test" href="./003840.htm">skin biopsy</a> and direct immunofluorescence test of the skin are performed. The health care provider may also recommend a <a test="test" href="./003416.htm">biopsy</a> of the intestines. Blood tests may be ordered to support the diagnosis.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>An antibiotic called dapsone is very effective.</p><p>A strict <a test="test" href="./002443.htm">gluten-free diet</a> will also be recommended to help control the disease. Sticking to this diet may eliminate the need for medicines and prevent later complications.</p><p>Medicines that suppress the immune system may be used, but are less effective.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The disease may be well-controlled with treatment. Without treatment, there may be a significant risk of intestinal cancer.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Autoimmune thyroid disease</li><li>Develop certain cancers, especially lymphomas of the intestines</li><li>Side effects of the drugs used to treat DH </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Call your provider if you have a rash that continues despite treatment.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>There is no known prevention of this disease. People with this condition may be able to prevent complications by avoiding foods that contain gluten.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Duhring disease; DH</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1406t.jpg" alt="Dermatitis, herpetiformis - close-up of lesion" title="Dermatitis, herpetiformis - close-up of lesion" class="side-img"/><a href="../imagepages/1406.htm">Dermatitis, herpetiformis - close-up of lesion</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2394t.jpg" alt="Dermatitis - herpetiformis on the knee" title="Dermatitis - herpetiformis on the knee" class="side-img"/><a href="../imagepages/2394.htm">Dermatitis - herpetiformis on the knee</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2400t.jpg" alt="Dermatitis - herpetiformis on the arm and legs" title="Dermatitis - herpetiformis on the arm and legs" class="side-img"/><a href="../imagepages/2400.htm">Dermatitis - herpetiformis on the arm and legs</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2674t.jpg" alt="Dermatitis herpetiformis on the thumb" title="Dermatitis herpetiformis on the thumb" class="side-img"/><a href="../imagepages/2674.htm">Dermatitis herpetiformis on the thumb</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2679t.jpg" alt="Dermatitis herpetiformis on the hand" title="Dermatitis herpetiformis on the hand" class="side-img"/><a href="../imagepages/2679.htm">Dermatitis herpetiformis on the hand</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2791t.jpg" alt="Dermatitis herpetiformis on the forearm" title="Dermatitis herpetiformis on the forearm" class="side-img"/><a href="../imagepages/2791.htm">Dermatitis herpetiformis on the forearm</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Hull CM, Zone JJ. Dermatitis herpetiformis and linear IgA bullous dermatosis. In: Bolognia JL, Schaffer JV, Cerroni L, eds. <em>Dermatology</em>. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 31.</p><p>Lebwohl B, Green PHR. Celiac disease. In: Feldman M, Friedman LS, Brandt LJ, eds. <em>Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management</em>. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 107.</p></div></div></section>
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