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However, in the majority of patients the enteropathy is mild and does not give rise to symptoms such as abdominal pain, weight loss and diarrhoea.Thus, all patients with DH have associated CD although it could be described as latent CD in the majority.The diagnosis of dermatitis herpetiformis is made by a simple skin test.A small piece of skin approximately 3 mms in diameter is taken from an unaffected area, ie. The skin is examined for the presence of a substance called Ig A (immunoglobulin A) and is found at a specific site in the skin.Dermatitis herpetiformis (DH) was first described as a distinct clinical entity in 1884 by an American dermatologist, Louis Duhring.

Now there is a more satisfactory and less hazardous treatment with a gluten free diet; although, it must be appreciated that drugs will control the rash within days but the diet will not.

Thus, drug treatment of DH has to be considered indefinite but it is not a cure for the disease.

It is important to find the smallest dose required to control the rash and this varies between patients.

a small intestinal biopsy and blood tests looking for specific antibodies, called anti-endomysial and tissue transglutaminase antibodies.

Occasionally in DH, the blood tests may be negative because their positivity correlates strongly with the severity of the intestinal lesion.It is important to appreciate that a gluten free diet may have no effect on the rash for approximately six months and sometimes, even longer.