|Basal Cell Carcinoma
|Squamous Cell Carcinoma
|Mycosis Fungoides (Sezary Syndrome)
|Pityriasis/Tinea versicolor infections
|Toxic Epidermal Necrolysis
|Atopic Eczema/Atopic Dermatitis
A strict gluten withdrawal from diet represents the basis for treatment
- Blistering rash + gluten sensitive enteropathy
- Lifelong disease with flare-ups and remissions
- Affects between 0.4 and 3.5 people per 100,000 of the European population.
- Typically affects Caucasians aged between 15-40 years
- More common in men, but can occur in all age and racial groups.
- Association with Coeliac disease which may be subclinical
- Subepidermal bullous disease with IgA deposition at the dermo-epidermal borders
- Autoantigen may be epidermal transglutaminase 3
- Incident 0.9 in Italy to 2.9 in Northern Ireland new cases per 100,000 per year
- There is a blistering intensely itchy vesicular rash over the extensor surfaces
- Small red spots, tiny fluid-filled blisters and wheals.
- Backs of the elbows, the fronts of the knees, the scalp, bottom and back.
- Gluten sensitive enteropathy may be asymptomatic
- Weight loss, diarrhoea or constipation, abdominal bloating and discomfort.
- FBC, U&E, LFTS, Folate
- Anti endomysial IgA antibodies
- Anti-tTG IgA antibodies
- Skin biopsy, performed by a dermatologist
- OGD and duodenal biopsies can confirm changes of coeliac disease
- Gluten free diet is key and needed lifelong and will reduce the need for other treatments
- Topical Medication. Strong steroid creams can be helpful in alleviating the symptoms of itch and are usually prescribed as an initial treatment whilst awaiting test results, or to control mild flares where oral medications are not necessary.
- Dapsone for the skin disease: Usually reduces itch within a few days. Can cause anaemia and other side effects.
- Oral steroids may sometimes be used