Dermatitis Herpetiformis Photos

Does Your Rash Look Like This? Gluten May Be Causing It

Licensed under Creative Commons/Courtesy of Dermnet

Dermatitis herpetiformis, an itchy, stinging skin condition associated with celiac disease, can be mistaken for various other skin conditions, and it can be difficult to diagnose.

When you have dermatitis herpetiformis ("DH" for short), your body reacts to the gluten protein found in the grains wheat, barley, and rye by attacking your skin. This attack results in the rash you see on your body.

Dermatitis herpetiformis isn't the only skin condition that's linked to celiac disease. Eczema—an itchy, scaly skin rash that's common in children but also occurs in adults—may be associated with celiac disease (and to non-celiac gluten sensitivity). And psoriasis—an autoimmune skin condition that leads to thick, red, scaly plaques on your skin that can be painful—also shares a strong link with celiac and gluten sensitivity.

However, dermatitis herpetiformis has the strongest link with celiac disease: if you've been diagnosed with this skin condition, you almost certainly have celiac disease. Dermatitis herpetiformis is treated with the gluten-free diet, and sometimes (especially immediately following diagnosis) with medication.

You'll need a skin biopsy to determine for certain if you have the condition. But you may be able to get an idea of whether it's a possibility by looking at these photos of different dermatitis herpetiformis cases.

Photo attribution: By Madhero88 [CC-BY-SA-3.0 (, CC-BY-SA-3.0 ( or CC-BY-SA-3.0 (], via Wikimedia Commons

Severe, Fluid-Filled Dermatitis Herpetiformis

© A.D.A.M. Medical Encyclopedia

When dermatitis herpetiformis is severe, the lesions often are topped with clear, fluid-filled blisters that pop easily when scratched (and it's pretty difficult not to scratch this itchy rash). The liquid in those blisters contains white blood cells, which are drawn to the area as a result of the autoimmune attack on the skin.

Dermatitis Herpetiformis on the Abdomen

Courtesy of Dermnet via Creative Commons

In this person, dermatitis herpetiformis appeared on the abdomen. In most cases, the rash will be symmetrical, which means it occurs on both sides of your body at once. In other words, if you have it on one side of your abdomen, you'll have it on the other side too, as this person does. However, if your rash isn't symmetrical, it doesn't necessarily rule out dermatitis herpetiformis.

Photo attribution: By Madhero88 [CC-BY-SA-3.0 (, CC-BY-SA-3.0 ( or CC-BY-SA-3.0 (], via Wikimedia Commons

Dermatitis Herpetiformis on the Knee

© A.D.A.M. Medical Encyclopedia

Dermatitis herpetiformis frequently affects the knees and elbows — again, usually in a symmetrical fashion (both sides of the body simultaneously). Although the gluten-free diet is the only recommended long-term treatment for the rash, the medication Dapsone can offer short-term relief for dermatitis herpetiformis sufferers. Unfortunately, though, Dapsone carries some significant risks, and doctors generally recommend you stay on it only for long enough to bring the rash under control and learn to eat gluten-free.

Severe Dermatitis Herpetiformis on a Child's Buttocks

Courtesy of Centers for Disease Control and Prevention

This severe case of dermatitis herpetiformis was seen in a four-year-old child, according to the Centers for Disease Control and Prevention. The photo — like the second slide — shows the fluid-filled blisters that often appear as part of the skin condition. Clinicians had thought until recently that the rash appeared almost exclusively in adults, but recent research shows children suffer from it, as well.

Dermatitis Herpetiformis on Elbow and Forearm

© A.D.A.M. Medical Encyclopedia

This person has the itchy rash on their elbow and forearm. As the lesions begin to heal, they'll usually turn from deep red to a shade of purple. Fading can take months, and even the tiniest amount of gluten consumption can aggravate the rash, causing it to flare up again.

Dermatitis Herpetiformis on the Legs and Arm

A.D.A.M. Medical Encyclopedia

This person has dermatitis herpetiformis lesions covering most of the legs and arms. The rash can be mistaken for several other conditions, including hives, acne, scabies, eczema and even bug bites or poison ivy (it's certainly as itchy as the itchiest of bug bites and poison ivy).

Dermatitis Herpetiformis on the Thumb

© A.D.A.M. Medical Encyclopedia

Although dermatitis herpetiformis more commonly is found on larger body parts (the buttocks, legs, knees, elbows, back, abdomen and scalp are the most frequent sites for this itchy rash), you sometimes can have it on your hands and thumb (where it can be very uncomfortable).

Dermatitis Herpetiformis on the Hand

© A.D.A.M. Medical Encyclopedia

This person's hand is swollen and discolored by dermatitis herpetiformis, showing that while the gluten rash doesn't usually occur on the hand, it can appear anywhere on the body. Fortunately, the two treatments for dermatitis herpetiformis (Dapsone and the gluten-free diet) will work on the rash regardless of where it occurs on your body.

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