Dermatitis herpetiformis is a rare skin eruption associated with Celiac's disease. It is caused by gluten fighting antibodies attacking the gut in the same way as Celiac's disease, but often people with dermatitis herpetiformis don't experience the usual symptoms such as bloating, diarrhea, and stomach cramps. Instead they develop a very itchy rash of red spots and fluid filled blisters.

Dermatitis herpetiformis can be treated by eliminating gluten from the diet, and will heal gradually, but some doctors recommend accelerating the healing process by taking a drug known as Dapsone. However, this drug has a number of side effects you should be aware of before deciding whether or not to take it. You should certainly be sure of the diagnosis of dermatitis herpetiformis before you take Dapsone, and this will involve a skin biopsy to get a definite result.

What is Dapsone?

Dapsone belongs to the sulphonamide family of medicines, and is an antibacterial drug. Originally it was used to treat leprosy, but more recently has been found to relieve other inflammatory diseases of the skin such as pyoderma gangrenosum, vasculitis and dermatitis herpetiformis.

Dapsone is available as a tablet of either fifty or one hundred milligrams. Because of the potential side effects, your doctor will prescribe as low a dose as possible and this will usually be between fifty and two hundred milligrams daily.

Potential side effects of Dapsone

All patients that take Dapsone experience a slight decrease in their red blood cell count and their levels of hemoglobin, which carries oxygen in the blood. This can cause a variety of symptoms including the following:

• Mild headaches, nausea or vomiting

• A blue tinge to the lips or fingertips

• Anemia

• Breathlessness

• Excessive fatigue

More severe symptoms associated with a large decrease in red blood cell count include:

• Fever

• Mouth ulcers

• Sore throat

• Bruising

• Depression

People that have a genetic condition called glucose-6-phosphate dehydrogenase deficiency are more likely to develop side effects of Dapsone, and this condition is more prevalent in those of Mediterranean, African and Asian ancestry. You can be tested for this deficiency before you begin to take Dapsone. Rarely, patients can be allergic to Dapsone, and they may experience a high fever, swelling of the glands in the throat and an additional rash.

Using Dapsone for a long period of time can cause impaired nerve function in the arms and legs, which can lead to weakening of the muscles in the feet and hands. It can also reduce fertility in men by reducing sperm count and mobility. For these reasons, Dapsone is used for as short a time as possible to relieve the symptoms of dermatitis herpetiformis while the gluten-free diet takes effect.

Monitoring of patients on Dapsone

Because of the side effects of Dapsone, patients usually undergo tests before the drug is prescribed, and every three months during the course of their treatment. These tests ensure your red blood cell count doesn't drop too drastically, and that your liver is functioning correctly. If you develop any side effects between routine testing, you should have a blood count test as a matter or urgency.

Why would I take Dapsone with so many side effects?

Although Dapsone does have a number of potential side effects, it has been used successfully to treat thousands of cases of dermatitis herpetiformis. It can relieve the symptoms of this chronic disease quickly, and help the sufferer to live a normal life while they are waiting for their gluten-free diet to take effect and repair the damage Celiac's disease has caused to their gut.

Simply eliminating gluten from your diet will usually stop the symptoms of dermatitis herpetiformis eventually, but you may have to live with the condition for up to two years, and it will return if you reintroduce gluten into your diet.