Signs and Symptoms

The classic finding of DH is itchy blisters and red skin lesions that occur in groups. Since DH is a skin manifestation of celiac disease, patients will also sometimes have gastrointestinal symptoms. These include abdominal bloating, cramping, pain, diarrhea, or constipation.


When a person with CD consumes gluten, the immune system responds by producing a type of antibody called immunoglobulin A (IgA). These IgA antibodies are directed against epidermal transglutaminase. These antibodies can travel to the skin where they bind to the epidermal transglutaminase protein.

The majority of patients with DH have CD as defined by damage to the villi in the small intestine. However, some patients may have a normal duodenal biopsy but nevertheless have their DH triggered by dietary gluten, which is why DH is sometimes referred to as “celiac disease of the skin”.

First-degree relatives of patients with CD and DH have an increased risk for CD and DH. The genes that are closely associated with both of these conditions are called HLA types.

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