Gluten-Free Diet
A strict gluten-free diet is the definitive treatment for dermatitis herpetiformis, addressing the underlying gluten sensitivity that causes this skin manifestation of celiac disease. The diet eliminates the trigger for IgA antibody deposition in the skin, gradually resolving the intensely itchy rash and blisters over several months to years. Most patients can eventually discontinue medication (dapsone) once the diet has been maintained long enough for antibody levels to decline.
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Confidence: High
Key foods: Certified gluten-free oats, brown rice, quinoa, fresh vegetables, fresh fruits, wild-caught fish rich in omega-3s, nuts like walnuts and almonds, seeds like flaxseed and chia
How does Gluten-Free Diet assist with Dermatitis Herpetiformis: Gluten ingestion triggers production of IgA antibodies against tissue transglutaminase in the gut, which cross-react with epidermal transglutaminase (eTG) in the skin. These antibodies deposit in the dermal papillae, activating complement and causing the characteristic blistering rash. Eliminating gluten stops this autoimmune process, allowing antibody levels to decline and skin lesions to heal, though improvement may take 6-24 months.