How Exactly Is Dh Diagnosed?

[The Horticulturalist]

My 7yr old was diagnosed with celiac via an endoscopy and +ve bloods back in October, he has been gluten free since then and I'm fairly sure that there are no cross contamination issues for him as I had been gluten free for a year prior to diagnosis.

So a few days ago he complained of being itchy, his skin on his trunk was dry and he was scratching a lot and even woke during the night. He has always been prone to dry skin and sensitive skin but that's about it.

last night I noticed that he had a rash on his inner elbows, the backs of his knees and all over his trunk and buttocks. It is made up of pinprick sized little spots with teeny tiny scabs on some of them and others look like little blisters, they are very small.

I can't get a dermatologist appt for several weeks and I think it will be gone by then, how important is it that we get a diagnosis for this do you think? I mean, he's already gluten free so I was a bit surprised to see this appear, however it's only been 8 weeks and it's entirely possible that he has had this in the past but I just never noticed.

I know the dermatologist personally, (from church) but we are not close or anything, I would need to be convinced that it was important for him to be seen soon in order to call her at home and see if she could squeeze him in. What do you all think?

Also, how exactly is it diagnosed, can she test for it in her office or does it need to be sent so a lab?

Edit: I have a photo of his arm that shows the rash, I don't know if I can post it here, if anyone can help with that I'll gladly post it.

Thanks for your help.

[pricklypear1971]

If he's dx'ed Celiac there's really no urgent need, except of you want to medicate him.

There are many skin conditions associated with Celiac. Try putting a super- moisturizing lotion on 2-3x per day. Ice packs help itching, and there's a thread in the board about using Oragel to stop itching.

He may be sensitive to iodone. The iodine reacts with the iga in the skin and makes the rash. You can try temporarily putting him on a low iodone diet to see of it helps. Google "thyca" for info on the diet.

I don't know why the rash would start up now, but this is the second mention of a rash starting post gluten-free, lately.

[itchy]

I have had new areas of rash start while being gluten free and while the original rash was almost healed. So I don't think it would be surprising for a new rash to form a while after going gluten free. Whatever factor causes DH seems to hang around the body and may trigger a reaction even after gluten has been eliminated.

It's also possible that he is still getting gluten. DH seems to be more sensitive to gluten than the obvious gastrointestinal symptoms. In other words his obvious GI symptoms could have abated while he is still getting enough gluten to trigger DH.

If he is gluten free, it is likely that the test won't work.

These are my experiences, other people have other experiences.

[squirmingitch]

If you read the post about Orajel then check out the link Dianedliam posted because it contains info. which is especially important re: children. I don't think I would try it on large areas on a child of mine. Just IMO.

The skin biopsy for dh has to be taken adjacent to an active lesion so that's a factor. But honestly, he has the diagnosis of celiac, you've got him going gluten free & that's the answer for both dh & celiac. So like pricklypear says unless you want to medicate him there's really no point in getting a Dr. diagnosis of dh.

[Di2011]

I would be careful with using benzocaine however it does seem to ease the itch.

As a parent with a child suffering DH I have something to say... this is the most itchy thing on earth and I hope that others have some alternative or something to say in addition.

These things on you childs skin aren't like mosquito bites.

For me it is like acid. Toxic "bits" ((not bites)) getting out of my pores. So incredibly itchy that whenever I type "itchy" I think there needs to be a new word for what it actually is like..

So if I don't "itch/cratch" and get "it" out then it will continue to itch and scratch and drive me crazy.

I know (as a mother myself) that this doesn't sit well. But my 6 months experience as a 38 year old mother with it head to ankle tells me that these things need to be scratched. There is no scientific research ((and I've spent 100's of hours researching)) but for some reason the "acid/toxin" has to get out.

Have you got into these "spots"? It isn't normal for a parent to squeeze/analyse etc but if you could describe them in detail (all detail as crazy as it seems) all the better for us to help. When do they occur/flare? What if anything do they seem to occur with (including time)?

I think I've always been celiac .. all the usual common (but less serious GI) symptoms but thought I was normal just allergic, bad diet etc etc etc

I went to work at a bakery and ended up DH head to ankle. I was always a itchy/scratchy person "just me". My son is showing DH since lowered gluten intake. His asthma, hay fever etc etc is non-existent (like mine) with mostly gluten free house hold. SO I know gluten is a problem. I think his "DH" is more obvious since going somewhat gluten free. I use to think it was the mosquito problem at school. Dumb huh? but who would have thought.

I do get some temporary relief from products with benzocaine as an active ingredient. Keep in mind though - I am in early days of experimenting and you must read about side effects. For example before testng the benzocaine product in the last week I had never had infection of lesions. But since, I have had three. It could be other factors, who really knows, but I'd be very careful if I was "testing" my child with benzocaine.

[squirmingitch]

I've not had any get infected since using the Orajel. You mentioned you were using something you got for Liam's sore throat --- maybe there's some other active (or inactive) ingredients in that which are causing you to get infections. The only active ingredient in the Orajel I'm using is 20% Benzocaine.

I wouldn't scratch them. I break the blister & that's it. No scratching as hard as it may be. I will rub the area around the place or use witch hazel on a pad & rub ON the lesion but NO SCRATCHING. Maybe that's why you're getting infections.

[The Horticulturalist]

Saw the dermatologist today, she thinks its eczema although it does look quite like DH. He has it on his inner elbows and behind knees, as well as other places but they are the worst, the DH pictures were all on the front of the knees and backs of the elbows.

And while it is itchy, it's not nearly as horrific as I've seen it described here and in other places. I also read that it's very rare in kids under 9, but I don't know how accurate that is.

I see her again in 6 weeks, if it's not responding to the eczema treatment by then she will biopsy it.

[ravenwoodglass]

Saw the dermatologist today, she thinks its eczema although it does look quite like DH. He has it on his inner elbows and behind knees, as well as other places but they are the worst, the DH pictures were all on the front of the knees and backs of the elbows.

And while it is itchy, it's not nearly as horrific as I've seen it described here and in other places. I also read that it's very rare in kids under 9, but I don't know how accurate that is.

I see her again in 6 weeks, if it's not responding to the eczema treatment by then she will biopsy it.

Your description and the areas where he is broken out are identical to where my DH broke out first when I was about 7 or so. It later spread to cover my arms and legs but I was of course still on gluten then. It was hell because when ever I would bend my arms or legs it would make the itching worse. Do delete iodine in supplements and salt until this resolves but don't leave iodine out long term as the body need it. Hopefully this will resolve for him soon.

[TriciaW]

Saw the dermatologist today, she thinks its eczema although it does look quite like DH. He has it on his inner elbows and behind knees, as well as other places but they are the worst, the DH pictures were all on the front of the knees and backs of the elbows.

And while it is itchy, it's not nearly as horrific as I've seen it described here and in other places. I also read that it's very rare in kids under 9, but I don't know how accurate that is.

I see her again in 6 weeks, if it's not responding to the eczema treatment by then she will biopsy it.

I have one son with DH and another with EXTREMELY sensitive skin. When you have one autoimmune disease in your genes, you are much more likely to have others. so.... what I am saying is, it very possible that he does have excema or contact dermatitis. I use 100 percent unscented everything on my son with excema... no fabric softeners and/or static sheets. I have only found one lotion that he can use -- even the ones the dermatologist recommended to us broke him out. The one that he can use it Aveeno -- but I can't use this on my son with DH because of the oatmeal in it.

Good luck!

[eatmeat4good]

Yeah, um, they keep saying DH is rare in children but if you are one of the children with it it's miserable. Should have diagnosed my son and myself long ago with DH, but the literature said it is rare in children and he was 7 and it also said DH rarely occurs on the face. Mine is on my face. Fast forward about 10 miserable years and we both have Celiac. So good you are aware of DH and can help your son. Sounds like his Dr. is willing to help too. Good luck to you. I sure wish someone would do a study to counteract the literature that says DH rarely occurs in children or on the face.

[mushroom]

The only place my hub had it was on his face.

[squirmingitch]

Why do Doctors think that "rarely" means NEVER? It rarely occurs on the face or in children therefore that means the child DOESN'T have it? Or the adult with it on their face DOESN'T have dh? Grrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

Have a friend whose hubby had appendicitis --- in the ER --- Dr. said he was too old (45 yrs. old) to have appendicitis so that couldn't be what was wrong with him. An hour later his appendix burst!!!!!!!!!!! Duuuuuuuuuuuuh. Good thing he was still in the ER. But it cost him in infection & recovery time.

[Di2011]

I think a lot of childrens DH is undiagnosed for a few reasons:

1. it looks like a single or just a few "mosquito bites"

because when more than one lesion they tend to be "grouped" so it appears similar

2. it is intermitent and/or located in one or just a few areas

3. highly dependent on gluten intake ie I avoided it for decades but with higher intake DH exploded (just as gluten intolerance explodes with others with GI/neuro symptoms for example)

I am 38 now but always put myself in the group of "mosquito bite" prone. Always "itchy/scratchy".

But I only went all-body from working in a bakery. Now I observe my 9 y/o son who has "mosquito bites" and I serious doubt we can blame the mosquito. It is intermittent and somewhat occasional. I am convinced now that at some stage in his life it will develop as mine did if we don't deal with it