Sharing evidence for natural healing methods that work.
Friday, April 14, 2017
Dermatitis Herpetiformis: Little Known Skin Disease That Is Surprisingly Common
(Excerpted from Healing without Medication)
Photo credit Louis Durhing Foundation
This disease few people have ever heard of is
more common than many would expect-
∆ Chronic skin eruption of itching lesions,
papules, and vesicles in clusters resembling hives
∆ Most common on the back, back of the neck,
buttocks, elbows, knees, and scalp
Understanding the Disease Process
herpetiformis is a disease that causes intense itching with a skin inflammation
resembling hives. Patients often have no sign of the original lesions by the
time they go to the doctor, because the itching is so intense and the original
areas of skin inflammation are covered by raw abrasions and crusts induced by
scratching. Itching frequently has a burning or stinging component. The onset
of burning and stinging reliably predicts the eruption of whelps on the skin
12–24 hours later.
The underlying cause of dermatitis
herpetiformis is a hypersensitivity to gliadin. This protein is a component of
gluten, which is found in all forms of wheat (including durum, semolina, and
spelt), rye, oats, barley and related grain hybrids such as kamut and
triticale. When someone who is sensitive to gliadin consumes these grains, the
intestine releases massive quantities of an immune protein called
immunoglobulin A (IgA). IgA is ordinarily the body’s first line of defense
against disease-causing microorganisms that enter through the skin and mucosal
In dermatitis herpetiformis, IgA
binds to cells in the skin and treats them as if they had become infected. The
body continues to secrete IgA, constantly inflaming the skin, until the
affected individual stops eating foods containing gliadin or until the immune
system becomes incapacitated. The benefits of changing diet, however, take
Dermatitis herpetiformis is usually
diagnosed by skin biopsy but there is a less painful alternative. Your doctor
can order a test for gluten sensitivity that measures gluten antibodies in
saliva. For information, ask your physician to contact Great Smokies Diagnostic
Laboratory in Asheville, North Carolina, 1-800-252-9303.
∆ Avoid all foods made with wheat or any other
grain containing gluten. Sources of hidden gluten include caramel, gum,
hydrolyzed plant protein (HPP), hydro lyzed vegetable protein (HVP), malt,
maltodextrin, modified food starch, monoglycerides, diglycerides, natural
flavoring, soy sauce, texturized vegetable protein (TVP), and vinegar.
∆ PABA (para-aminobenzoic acid):
• Three 500-milligram extended-release
tablets taken with food, 3 times daily, or
• Aminobenzoate of potassium powder,
one 2-gram packet taken with food, 3 times daily.
For no longer than 3 months:
∆ Selenium: 200 micrograms daily.
∆ Vitamin E: 1,000 IU daily.
Understanding the Healing Process
dermatitis herpetiformis with diet takes several months, many people with the
condition opt to be treated with the antibiotic dapsone. This drug relieves
symptoms in 24–48 hours, but anyone who takes more than 100 milligrams of the
drug per day develops anemia. Other side effects may include damage to the bone
marrow and liver, headache, and depression. Since the rash returns very quickly
when the antibiotic is discontinued, the typical treatment strategy with
dapsone and other agents for dermatitis herpetiformis is to find the lowest
dosage possible while controlling symptoms, so that side effects diminish over
time. As a British expert on the disease, Dr. Lionel Fry, notes, “Since side
effects tend to occur early in treatment, patients may only have to attend
hospital every six months once established on drug treatment.”
Although natural healing of
dermatitis herpetiformis requires discipline, it is free of side effects. Many
sufferers of this form of dermatitis will choose the middle ground between
medical and natural treatment, taking prescription drugs in the short term to
control symptoms while waiting for diet to control the underlying disease.
A gluten-free diet is key to healing
dermatitis herpetiformis. A 25-year study of dermatitis herpetiformis in the
United Kingdom found that about a third of patients experience complete
remission of symptoms simply by removing wheat and other gluten products from
the diet. Virtually all of the remaining two-thirds of patients achieved
partial relief of symptoms by just partial adherence to the diet. People
with this condition who follow a gluten-free diet are also at much lower risk
for developing lipomas, tumors of fatty tissue just beneath the skin.
Most medical authorities note that
about 10 percent of people with the disease do not respond even to rigorous
elimination of gluten products from the diet. Eliminating milk and eggs can
help most of the dermatitis herpetiformis sufferers in this group. An
enzyme-linked immunosorbent assay (ELISA) of dermatitis herpetiformis patients
has found that about 75 percent have serum antibodies reactive against gliadin,
cow’s milk, or the albumin protein in eggs. Completely eliminating
milk and eggs followed by carefully reintroducing them in small amounts several
months later is a good test of the potential efficacy of permanently eliminating
them from the diet. Some milk- and egg-sensitive dermatitis
patients will be able to tolerate small amounts of these foods if they strictly
adhere to the gluten-free diet.
A single study in the 1950s found
that treating dermatitis herpetiformis with very large dosages of PABA
(9,000–24,000 milligrams per day) controlled symptoms for as long as 30 months.
Symptoms of the disease rapidly recurred when PABA supplementation was stopped. There is no evidence that taking as much as 24 grams (24,000 milligrams) of
PABA daily causes any serious side effects. However, to provide a margin of
safety, naturopathic physicians usually recommend taking no more than 6 grams
(6,000 milligrams) of the supplement daily for no more than 3 months. Always
take PABA with a full glass of water to avoid the nausea and vomiting that
sometimes comes with taking high dosages of the supplement.
There is no direct evidence that
selenium and vitamin E relieve symptoms of dermatitis herpetiformis. However,
both vitamins protect an antioxidant enzyme known as glutathione peroxidase,
which is known to be deficient in dermatitis herpetiformis. Clinical trials
confirm that supplementation with these two vitamins corrects glutathione
peroxidase deficiency in 6–8 weeks, and levels continue to increase for at
least 5 months, however, there is no immediate effect on symptoms of the
Concepts for Coping with Dermatitis
∆ If a gluten-free diet causes constipation, try
drinking more water, increasing servings of fruits and vegetables.
∆ Non-food products such as lipstick, medications
in pill form, and toothpaste may contain gluten. Health and beauty aids that
are not ingested in normal use may be accidentally ingested when fingers come
in contact with the mouth. In some cases, skin contact with a gluten is enough
to cause a reaction.
∆ “Starch” in the United States is usually corn
starch, which is safe for people who have dermatitis herpetiformis. “Starch” in
Europe, however, is usually wheat starch, which will cause a skin reaction.
∆ Many people with dermatitis herpetiformis buy
bread machines to take advantage of the many gluten-free bread mixes available
on the market. If you are buying a bread machine, keep in mind that gluten-free
bread mixes are very heavy and not every bread maker can process them. Brands
of bread makers that process gluten-free dough include the Black & Decker
All-in-One (Model B1500–04), all Wellbilt machines (sold at Sears), and the
very expensive Zojirushi BBCCS-15.
∆ Be careful not to take any brand of vitamin E
extracted from wheat. The formulation of vitamin E made by A. R. Grace &
Company is safe for people with dermatitis herpetiformis, but the capsules
themselves are made with beef gelatin and are neither halal nor kosher.
∆ Avoid fried foods, especially in fast-food
restaurants. French fries are usually cooked in the same oil used to prepare
∆ If you drink alcohol, avoid beer (including rice
beer, which contains malt), bourbon, gin, rye, and whiskey. Most vodkas do not
cause a problem, and rum, sake, tequila, and wine are generally safe.