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Dermatitis Herpetiformis

Dermatitis herpetiformis is a chronic, intensely itchy blistering rash caused by gluten-driven autoimmunity associated with coeliac disease.

Aczone

Dapsone

100mg

Indicated for acne vulgaris utilized to target inflammatory skin lesions.

From$0.05/ tabletView

Key takeaways

  • Symmetrical grouped bumps and blisters on elbows, knees, buttocks or scalp are often scratched before intact blisters are seen.
  • Diagnosis relies on a biopsy of normal-looking skin beside a lesion for direct immunofluorescence.
  • A strict lifelong gluten-free diet treats the underlying disease, while dapsone controls skin symptoms but requires blood monitoring.

The listings below do not confirm the diagnosis; dapsone has important blood, liver and nerve risks and needs clinician supervision.

Coeliac antibody testing supports assessment, but starting a gluten-free diet before biopsy can reduce diagnostic yield. Digestive symptoms may be mild or absent despite small-bowel involvement. Nutrition review includes iron, folate, vitamin status and bone health.

Treatment and monitoring

Skin improvement from dietary treatment takes time, and even small ongoing gluten exposure can maintain disease. Dapsone may relieve itch rapidly but can cause haemolysis and methaemoglobinaemia; baseline and follow-up blood counts, liver tests and appropriate G6PD consideration are required.

When to seek urgent care

Seek urgent care for breathlessness, blue or grey lips, severe weakness, jaundice, dark urine, fever, widespread blistering or mouth and eye involvement after starting treatment.