Contact Dermatitis?

[Twoxxmom]

I have been itching for about 5 months now. I have gone to the dermatologist a number of times and been told pruitis, eczema and dermatitis. I have been given antihistamines and ointments and changed shampoo, conditioner, soap, detergent. So far, nothing has totally cleared this up. A recent biopsy (on a lesion) came up as an allergic contact dermatitis. I am now being refer to an allergist. I have different kinds of rashes (small rashes that itch and bleed and cover a large area especially on my back and drier/"sandpapery" rashes that are raised and reddened and right now are mostly on my neck). The rashes seem to crop up in very similar if not identical places on opposite sides of my body. Just wondering if an allergist can help me, or if I need to look elsewhere. I'm getting very frustrated. Any advice would be appreciated. Thanks!

[squirmingitch]

First, dh is not biopsied DIRECTLY ON a lesion. It will turn up a negative. DH is biopsied ADJACENT to an ACTIVE lesion. And then it is stained with a special stain & the derm has to specify to the lab to test for dh or it won't be done.

I think you need to find a different derm. One who is familiar with taking biopsies of dh.

[Twoxxmom]

  On 4/17/2012 at 1:34 AM, squirmingitch said:

First, dh is not biopsied DIRECTLY ON a lesion. It will turn up a negative. DH is biopsied ADJACENT to an ACTIVE lesion. And then it is stained with a special stain & the derm has to specify to the lab to test for dh or it won't be done.

I think you need to find a different derm. One who is familiar with taking biopsies of dh.

That's what I mentioned to her when she said they were doing a biopsy. I had researched this before going in the last time I went, so I am not really sure what this told me (being that it was ON the lesion). Maybe I will have better luck with an allergist.

[LillieD]

I had watery, itchy, and burning blisters on both knees and both elbows for the longest time. I was being treated by my Primary doctor and was prescribed ointment after ointment with no relief at all. Before being referred to a dermatologist by the request of my husband I was getting the blisters on my wrist, ankles, waist, and rear. After being visually inspected by the new doc and his nurse it was concluded that I had psoriasis and given an article all about it. I insisted I didn't have psoriasis and wasn't satisfied until the doc took 3 biopsies, 1 from a bump before the blister, a blister, and 1 dried up. He sent two off to different labs and kept one at the hospital lab. They all came back positive for DH. He prescribed Dapsone 100mg 1 tablet daily and told me I could take the pills or change my diet. Meanwhile I was referred to a GI for a biopsy of my small intestines. He said most people with DH also had celiac disease. I only had to take a few of the pills before the rash was completely gone. I was totally motivated to stay on the gluten free diet because the DH was maddening. My GI told me I did in fact have celiac disease and my small intestines was in the process of being healed. Good News!! That was in October of 2010 and I've been on the gluten-free diet without the Dapsone. I still have problems with bloating, low energy, painful joints and muscles (I also have fibromyalgia)and suspect I might be getting a trace of gluten from somewhere. I hope this has helped you and maybe someone can enlighten me about the rest of my symptoms.

[itchy]

twoxxmom: DH tests are notoriously unreliable. If they say you have DH you probably do. If they say you don't have it, the result cannot be trusted in my opinion, based on the experience of a large number of people who have posted here in the past.

As suggested above, if Dapsone works, it is DH.

Some other indications would be if the areas around your sores are red and inflammed. And if you have gastrointestinal problems. In most people with DH the gastrointestinal issues are less than in celiacs without DH, in others even non existent. But many of us do have GI issues, and this is often a tipoff that the rash is DH.

The symptoms that you describe are certainly characteristic of DH, and I wouldn't let anyone rule out DH simply on the basis of a test.

It is an aggravating condition, unpleasant to have, difficult to get rid of, and hard to identify with absolute certainty.

[Twoxxmom]

Thanks for your responses and help. It is much appreciated. From what I hear it is tough to get the diagnosis. I am seeing an allergist next. Any thoughts on allergy testing? Will allergy testing help the process or just delay it? Thanks again!

[IrishHeart]

  On 4/17/2012 at 2:13 AM, LillieD said:

They all came back positive for DH. He prescribed Dapsone 100mg 1 tablet daily and told me I could take the pills or change my diet. Meanwhile I was referred to a GI for a biopsy of my small intestines. He said most people with DH also had celiac disease.

Actually, he should have said that ALL people with DH have celiac. DH is the skin manifestation of celiac disease.

It's not a "take the pills OR go gluten-free" -gluten is what CAUSES DH.

When a person with celiac disease consumes gluten, the mucosal immune system in the intestine responds by producing a type of antibody called immunoglobulin A (IgA), explains John Zone, M.D., chairman of the Department of Dermatology at the University of Utah School of Medicine. As IgA enters the bloodstream, it can collect in small blood vessels under the skin, triggering further immune reactions that result in the blistering rash of DH.

Your continuing symptoms could be from various triggers. Gluten is the underlying cause, but some people on here with DH and other continued symptoms, despite a gluten free diet, say that other food intolerances can cause joint pain and bloating, including dairy and salicylates.

Have you had your vitamin levels checked?

[pricklypear1971]

You need to see a dermatologist to get a biopsy for DH. Be warned, if you are using steroids for the rash it can invalidate the testing.

Also, dapsone can be prescribed for Linear IgA Disease and I believe a few others. But if it works it's a very good indicator.

[squirmingitch]

Also you need to be consuming gluten even for the dh biopsy.

[itchy]

'Also, dapsone can be prescribed for Linear IgA Disease and I believe a few others. But if it works it's a very good indicator.'

Yes, I apologise for my misinformation. Not having considered taking it I don't know much about it.