Gluten responsible for skin rash

HARARE - If one suffers from intense itchy skin rash and does not seem to respond to treatment, it is possible that the skin rash could be dermatitis herpetiformis.

Local dermatologist Elizabeth Mwanakudzi said this skin condition is caused by gluten in the diet, which occurs naturally in the grains wheat, barley and rye.

“Zimbabweans consume large quantities of gluten several times each day when they eat cereal, bread or pasta,” she said.

“In dermatitis herpetiformis, the skin erupts when one consumes those grains. Almost everyone with dermatitis herpetiformis has the intestinal damage that characterises celiac disease, but not everyone with celiac disease will also have a skin rash,” said the dermatologist.

Mwanakudzi said dermatitis herpetiformis sufferers often describe their rash as almost unbearably itchy.
“The itching usually starts before the pimple-like lesions erupt. The red lesions which often have a clear liquid centre usually form in clusters, and usually appear in the same place on your body every time. Healing lesions leave black spots,” she said.

She said if one constantly consumes gluten, they may have the rash constantly, but it sometimes wanes and then returns.

“Common locations for dermatitis herpetiformis include the elbows, knees, buttocks and chest. If dermatitis herpetiformis is suspected one should visit the nearest dermatologist,” said the doctor.

“The doctor most likely will perform a skin biopsy, which involves taking a small sample of the skin right next to an active lesion. The dermatologist then will examine the sample under a microscope to see if it shows the tell-tale signs of dermatitis herpetiformis.

If it does, the patient may also be referred to a gastroenterologist, who will determine if the intestinal damage from gluten ingestion,” Mwanakudzi.

She said the dermatologist may offer some short-term relief from the symptoms in the form of a prescription medication, which can quickly curb the itching.

“Therefore, treating  dermatitis herpetiformis long-term will involve following the gluten-free diet, which means giving up gluten-containing items and substituting gluten-free breads, pastas and other products. Fortunately, food manufacturers now offer an increasing array of gluten-free foods and following the gluten-free diet shouldn’t be too difficult,” said Mwanakudzi.

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