Skin is the largest organ of the human body, it’s considered to be the mirror of what’s going on inside our body. Many a times number of diseases first manifest as skin problems, when a skin problem is present for a long duration and not responding to treatment, then we try to find the underlying cause and this leads to investigations and regular follow ups, this may lead to a diagnosis. For example diabetes is often diagnosed from skin rashes and recurrent infections. Similarly gluten sensitivity or coeliac disease can present with skin problems; certain skin diseases manifest more frequently in people with gluten sensitivity.

Coeliac disease is an autoimmune disease which affects the digestive tract, it’s the severe form of gluten intolerance. A few may just have gluten intolerance and not the coeliac disease. It can present with different symptoms like bloating, abdominal pain or discomfort, loose motions or constipation, feeling of tiredness, headache and many others like skin problems. I shall deal with skin problems here.

Many people present with long standing itching, redness, rashes and even blisters sometimes. In such individuals of long standing skin rashes, I always get them tested for gluten sensitivity. A few present as eczematous lesions, which are to begin with  dry patches of intense itching which may be labelled as dermatitis and when they become oozy because of persistent itching or secondary infection then it’s known as eczema. Eczema more frequently seen in children. Another presentation is with hives (commonly known as chappaki/thaphad) and diagnosed as urticaria by a dermatologist. Dryness of the skin is often noticed by the patients, this is explained on the basis of poor absorption of nutrients from the damaged digestive tract, here your doctor can give you multivitamin supplements and a dietician can help you improve your diet. Keep your skin hydrated by drinking of plenty of fluids, diet rich in nutrients which help in skin hydration and apply good moisturising lotion. Very important to keep the skin well moisturised as it will otherwise lead to itching. Darkening of the skin is also a result of poor nutrients and dryness of the skin. 

Dermatitis Herpetiformis is a skin disorder very frequently associated with gluten sensitivity and coeliac disease. It presents as itchy, red dots (papules) and vesicles (tiny blisters filled with clear fluid), they can appear anywhere on the body but most frequently seen on back, elbows, knees and buttocks. The person may complain of mild to intense burning sensation on the skin. The diagnosis is confirmed on biopsy. Whenever someone presents with dermatitis herpettiformis, we always test them for gluten sensitivity and screen for coeliac disease. Dermatitis herpetiformis May be the first presentation or it can also present after the diagnosis of coeliac disease. It can be well controlled by treatment from a dermatologist and following strict diet restrictions for gluten.

As coeliac disease is an autoimmune disorder, it can be associated with any other autoimmune disorders, the skin disorders could be alopecia areata, urticaria, dermatitis herpetiformis. Psoriasis is also seen to be seen along with coeliac disease.

All of the above skin conditions can be well controlled with the help of a dermatologist in Ludhiana and a dietician. Very important is the strict adherence to a gluten free diet. We are lucky now as we have many alternatives for gluten free meal plans and snacks. The family plays a very important role for the emotional support and guidance for these children and adults. Positive attitude with healthy eating goes a long way in living a symptom free life.