Magan Medical Clinic, Dermatology
We provide quality dermatology care with compassion. Our specialty is medical dermatology, including:
If you have hair thinning or psoriasis, Dr. Chiang possesses special expertise. He completed fellowships in both fields at University of California, San Francisco where he saw a wide spectrum of patients (including the most severe), performed clinical trials, and published research.
We take pleasure in serving our community including Covina, West Covina, San Dimas, Rancho Cucamonga, Baldwin Park, Azusa, Glendora, Upland, El Monte, Duarte, Monrovia, Arcadia, La Puente, and Diamond Bar.
Same day appointments often available. No referral is necessary for PPO insurance plans. Please call (626) 331-6411. We look forward to serving you!
"What’s New in..."
A monthly column by Dr. Chiang
What’s New in Dermatitis herpetiformis
Most people have heard of celiac disease, an autoimmune disease where the ingestion of gluten (a protein found in certain foods, esp. the “big 3” of wheat, barley, & rye) causes the body to become inflamed. In dermatology, we see patients where the inflammation in the bowel spreads to the skin as well. This leads to the disease called dermatitis herpetiformis (which confusingly enough, has nothing to do with herpes). It results in intense itching, esp. on the elbows, knees, and buttocks. It is usually seen in middle age patients or older, almost never in children. Usually, a biopsy is performed to confirm the diagnosis.
Thankfully, a medication called dapsone usually works well for the itching and the rash. However, it does have side effects. It also doesn’t protect against the disease’s internal effects, including lymphoma (~30% increased risk in those with DH, esp. in the gastrointestinal tract and nearby lymph nodes. Different sources report widely different risks, however) and osteoporosis (seen in 50% of DH patients vs. 30% of control patients).
Thus, the theoretical treatment is a gluten-free diet. By avoiding gluten, the disease goes into remission, with the itch and rash disappearing and protection against lymphoma occurring. However, my patients hate the thought of giving up gluten, esp. bread. In the past, I’ve tried to do my own diet discussions, but with the increasing usefulness of the internet nowadays, most motivated patients find the Celiac Disease Foundation’s website to be most helpful:
Many stores have gluten-free sections nowadays. However, some patients may like an online store specializing in gluten-free products: (no relationship, financial or otherwise)
If you have dermatitis herpetiformis or have any other questions, please make an appointment for dermatology consultation at (626) 331-6411.
Charles Chiang, MD, FAAD
- Lorinczy K, et al. Does dermatitis herpetiformis result in bone loss as coeliac disease does? A cross sectional study. Rev Esp Enferm Dig 2013
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