Dermatitis herpetiformis

Alternative names
Duhring’s Disease


Dermatitis herpetiformis is a chronic, extremely itchy rash consisting of papules and vesicles. Dermatitis herpetiformis is associated with sensitivity of the intestine to gluten in the diet (celiac sprue).

Causes, incidence, and risk factors

Dermatitis herpetiformis usually begins in the twenties, though children may sometimes be affected. It is seen in both men and women.

Though the cause of the rash is unknown, dermatitis herpetiformis is frequently associated with gluten (a protein found in cereals) sensitivity in the small bowel.

Dermatitis herpetiformis is usually extremely itchy. The vesicles or papules usually appear on the elbows, knees, back, and buttocks. In most cases, it is highly symmetric. Symptoms of dermatitis herpetiformis tend to wax and wane.

Signs and tests
A skin biopsy and direct immunofluorescence test of the skin are performed in most cases. Your doctor may additionally recommend a biopsy of the intestines.


Dapsone, an antibiotic, may help the majority of patients.

A strict gluten-free diet will also be recommended to help control the disease. Adherence to this diet may eliminate the need for medications and prevent later complications.

Support Groups

The Celiac Sprue Association may offer support for people with dermatitis herpetiformis.

PO Box 31700, Omaha, NE 68131
(402) 558-0600

Expectations (prognosis)
The disease may be well controlled with treatment.

Thyroid disease may be found in many patients with dermatitis herpetiformis. Patients are also more likely to develop certain cancers of the intestines.

Calling your health care provider
Call your physician if you develop an itchy rash or diarrhea.

There is no known prevention of this disease. Avoidance of gluten containing foods will help prevent complications in affected patients.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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