What is Herpetiform Dermatitis?

Herpetiform dermatitis is a skin irritation caused by deposits of IgA antibodies in the layers of the skin, leading to an immune system reaction and inflammation of the skin. This skin condition is specifically seen in people with gluten sensitivity, such as patients with Celiac disease and gluten intolerance. It can be extremely painful, as well as irritating. Treatments are available to manage the outbreaks and prevent them from occurring in the future.

The term “herpetiform dermatitis” may lead patients to believe that this condition is associated with herpes, a skin outbreak caused by a virus. This is not actually the case; the name is a reference to the fact that it superficially resembles herpes outbreaks. Herpetiform dermatitis takes the form of a number of small fluid filled blisters surrounded by reddened, rough, irritated skin. It is also known as herpetiformis dermatitis or Duhring's disease.

For patients, the appearance of lesions is usually preceded by a feeling of intense heat and pain for several days. Once the skin breaks out, it is extremely itchy. Patients with herpetiform dermatitis may create large ulcerations in their skin by scratching, and it is possible to develop infections as bacteria and other organisms take advantage of the openings in the skin. The outbreak can occur anywhere, although the arms and legs are common locations, and can last days or weeks, depending on how it is managed.

Medications can be prescribed to address the outbreak, including topical applications to reduce the itching sensation. Patients may also be advised to wear lightweight clothes to cover the blisters and to consider using gloves at night so they cannot scratch themselves by accident. The resemblance between herpetiform dermatitis and herpes may lead doctors to advise their patients to alert people to the fact that it's an immune system reaction and is not contagious, not presenting any risks to people who come into contact with the patient.

For long-term prevention of herpetiform dermatitis outbreaks, it is necessary to completely cut gluten out of the diet. As the intestines recover from inflammation caused by gluten sensitivities, issues like skin outbreaks should resolve. Should the patient eat gluten again, a flareup can occur. Patients with gluten sensitivity need to be especially wary about hidden gluten in fillers used to make food less expensive, as well as gluten in surprising places, like candy and medications, where one would not normally expect to find grains.