The little known skin condition that could save your life

Back in the day when I was diagnosed with inflammatory arthritis, it was my horrible, embarrassing secret and no one except my girlfriend (now wife) knew, absolutely no one.

But then when I developed psoriasis, there was no hiding it. My shame was plain to see across my hands and legs, a daily reminder of my own perceived failings.



Ultimately, the majority of skin issues are inflammatory based and the roots are a combination of inflammatory provocateurs (foods, infections and toxins) and deficiencies of key nutrients.

Thus these issues are multifactorial, with one exception.

Dermatitis herpetiformis.

This angry condition is truly monogamous in a world of promiscuous skin conditions.

When you see it, you know their immune system has taken aim at…….gluten.

There is no other cause, none.

The treatment?

A life long gluten free diet, ideally filled with real, whole foods not just processed gluten free junk food.

A whopping 90% at least will have gluten sensitivity with full enteropathy.

We used to called this Coeliac disease and many still do, but it creates confusion for those with gluten sensitivity without enteropathy.

Ultimately a heightened reaction to the protein found in gluten, creates a sustained inflammatory response. If you have the HLA DQ2/8 gene, then you have the potential to develop complete flattening of the villi, and this was known as Coeliac disease. But the cause is gluten sensitivity and you can have that with or with out the enteropathy.

Thus we now call the group of issues you can get from gluten sensitivity, gluten related disorders.


Otherwise we get lost into non-coeliac gluten sensitivity, which misses the point that gluten is the issue not the Coeliac bit per se.

Anyone suspected of having dermatitis herpetiformis should be offered testing for gluten sensitive enteropathy (aka coeliac) according to NHS NICE guidance.


Check out some of the key symptoms



It can vary in presentation, but the common part is symmetry and angry red bits.





If they are negative for enteropathy on blood testing, advise them to try a gluten free diet.

It may be they are in process of developing enteropathy, but the villi are only partially damaged and at this stage the blood tests are very unreliable, often well below 50% accurate.


– Keep those eyes peeled for skin rashes, even if they have been given a name for it by a GP or pharmacist, you might be the one to spot it the real diagnosis.

– If in doubt a 2 week gluten free diet is always warranted for any inflammtory issue.

– My skin is all good now, thanks for asking.