Dermatitis herpetiformis is a chronic skin disorder that causes blisters and a very itchy rash on the skin, particularly on the elbows, knees, back, and scalp and rarely on the face. It is also known by the names dermatitis multiformis, Duhring's disease, and gluten sensitive enteropathy. This condition generally occurs in people between 20 to 40 years of age, however, it can affect children and elderly as well. Inflammation of the skin is usually linked to celiac disease or an intolerance to the protein known as gluten. It has also been reported to occur in people with autoimmune thyroid disorder, vitiligo, type 1 diabetes, and rheumatoid arthritis. As mentioned above, dermatitis herpetiformis is mostly associated with a bowel disorder known as celiac disease. Celiac disease is an autoimmune disorder characterized by the inability to tolerate the wheat protein, gluten. The digestive lining of the people affected by celiac disease, is sensitive to gluten and fails to produce adequate amounts of digestive enzymes. This dermatitis occurs as one of the first symptoms of celiac disease. It is distinguished from the other skin conditions by the extreme itching that accompanies the rash. The red itchy rash followed by bumps and blisters continues for a long period of time. Symptoms Dermatitis herpetiformis causes a number of tiny blisters, discrete papules, or bumps and smooth lesions on the skin. It can affect any part of the body but the blisters are usually distributed symmetrically on the elbows, knees, back, and buttocks. The papulovesicular eruptions are extremely itchy and can cause a stinging or burning sensation too. Scratching further irritates the skin and can aggravate the condition. The lesions usually begin with discoloration of the skin in that area, followed by intense itching and burning. Small bumps then erupt from the skin, which are known as papules. These lesions generally occur in groups like that of herpes. Hence, the name dermatitis herpetiformis, which means the skin inflammation is much similar to herpes. The blisters develop crusts and tend to lose their itching sensations after a certain period of time. The symptoms may range from mild to severe. They may sometimes be accompanied by the symptoms of celiac disease such as abdominal pain and unexplained tiredness. In fact, inflamed skin may be the first sign of celiac disease in some people. Treatment It is seen that medication and changes in the diet have a positive effect on this medical condition and the problems related to it. Dapsone, an antibacterial drug, is believed to be effective in controlling the blisters rash. The antibacterial and anti-inflammatory action of Dapsone, stops the itching and treats the skin condition. Some other drugs that can be used to treat the condition include sulfapyridine, tetracycline, colchicine, and nicotinamide, however, they may not be as effective as Dapsone. It is important to note that any kind of medication to treat this medical condition should be taken only after consulting a qualified health care professional. The simplest way to reduce the severity of this skin condition is by following a strict gluten-free diet. Gluten is present in food such as oats, wheat, rye, and barley. It is also present in malts, hydrolyzed vegetable proteins, artificial colors, and preservatives. These foods trigger the skin condition and hence people who are sensitive to gluten should strictly avoid them to prevent flare-ups. Identifying the symptoms in the early stage can help in effective treatment of the condition. Although medication reduces the skin rash quickly, strict adherence to a gluten-free diet controls the conditions as well as prevents its recurrence. Disclaimer: This Buzzle article is for informative purposes only, and should not be used as a replacement for expert medical advice.