Gluten and the skin

Dermatitis herpetiformis (DH) is a skin disorder associated with coeliac disease. Coeliac disease (CD) is a disorder of the small intestine caused by an autoimmune response to gluten, the protein component of some grains.
Namely, wheat, rye barley, oats. In other words, it is gluten intolerance.

Dermatitis herpetiformis is often referred to as “coeliac disease of the skin”, while CD is referred to as “coeliac disease of the gut”.

DH is characterized by a very itchy skin rash distinguished by the eruption of small papules or blisters. These blisters have a burning, stinging sensation and often occur in crops, taking up to 7–10 days to lose their itch, and then begin to crust. The IgA antibodies produced by the mucous membranes (of the nose, throat, lungs and gut) in response to gluten circulate in the blood stream, settling in the skin causing the intense reaction labelled DH. It is currently believed that oats do not cause HD.

If you have experienced a rash which resembles the above description, the first thing to do is to rule out CD. Coeliac disease is diagnosed firstly by a blood test and then confirmed by a small bowel biopsy. The blood test will reveal elevated anti-gliadin or endomysial antibodies and biopsy will confirm small intestinal disease with crypts in the intestinal villi.

Once gluten is removed from the diet the DH rash will disappear, and your small intestinal villi will eventually return to normal.