Sign of Celiac?

[dinkydonuts]

I have a rash on my face, one leg, back, and arm. It consists of  small red bumps that get clear pus in them. Usually, they erupt after I eat wheat. However, even when I have been wheat-free, I break out every once in a while. The spots usually don't itch very badly, but today they are. Also, I get open sores inside my nose after eating wheat. I have already been told that I have a wheat allergy and that I'm allergic to dust and some grasses. I have been eating wheat more often lately, and I've been breaking out more often. I've also been having more stomach problems, like mucus in or around my feces and more heartburn. A couple years ago I was tested for ANA and it was positive 1:80, but it calmed down and was negative last time I was checked (August 2003). In addition to the rash, I have arthritis in every joint except my hips, a herniated disk in my back, pain in my rear/hip, pain and numbness in my left leg, and a completely numb big toe on my left foot. Last year, I had a biopsy to test for celiac, and it came back negative, but I had only had gluten for 2 weeks prior to that test. Could all this be a sign that I do indeed have celiac disease (and dermatitis herpetiformis), or do you think the symptoms are signs of something else?

Thanks,
Dinkydonuts

[Alan Rockoff, MD]

This certainly does not sound like dermatitis herpetiformis.  Those who have that condition are so sensitive to gluten that even the tiniest amount triggers it.

I'm not sure why you're concerned about such a rare condition, but I think you need a consultation with a gastroenterologist to set you straight about whether or not you have celiac, and with a dermatologist who can tell you what you really do have, which is probably something mild and nonspecific.

An ANA of 1:80 generally means nothing at all, by the way.

Take care.

Dr. Rockoff

[dinkydonuts]

First, I don't consider one person in every two hundred rare. According to the latest statistics on Celiac, that is the rarest it could be. Second, many doctors consider an ANA of 1:80 to be borderline for Lupus, which is what they said they thought I had when that was found. They changed their mind, but it still haunts me. I have made an appointment with a dermatologist, but like most doctors I have found, it is for an entire 6 weeks from now, so I'd like to see if I can get any answers through this forum. Does itchy, red, pus-filled bumps sound like eczema, or anything else anybody else is familiar with? Or do you all think this is some kind of isolated allergic reaction to wheat? Any ideas about treatment?

[Alan Rockoff, MD]

1. I haven't seen a single case in 25 years, which I think justifies calling it rare.
2. Borderline lupus is not lupus.  Besides, the test became negative, which does not happen in lupus.  Besides, what does lupuis have to do with dermatitis hepretiformis.
3.  Why not see a gastroenterologist too, to clarify what your GI status is?

Dr. Rockoff

[Curious1]

Having been diagnosed as having celiac disease (CD) by the small bumps on knees, elbows, hairline and at the base of tailbone, I can tell you they were never red and pus filled.  DH looked to me like small water blisters, itched like blue blazes and would NOT scratch off no matter how I tried.  It took a biopsy to confirm DH, then an endoscopic biopsy confirmed celiac disease.

[Curious1]

For any diagnosed celiac patients I would like to add this post script; I use a prescription called Clobetasol Propionate Ointment when these bumps occur.  Stops the itch and they disappear within a day or two.