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Dr. David
Dr. David, Board Certified MD
Category: Dermatology
Satisfied Customers: 42805
Experience:  Board Certified Physician
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I have a twelve year old patient who has celiac disease and

Customer Question

I have a twelve year old patient who has celiac disease and geographic tongue.He has been on a gluten free diet for more than one year and his blood counts have returned to normal levels. One year ago he had gastroenteritis, since then he has had continous abdominal pain. Endoscope shows minor inflammation in the small intestine otherwise nothing exceptional. Ultrasound scans are clear. The whole abdomen is tender to touch and remains so when the abdominal musculature is contracted. Palpation of the abdomen reveals widespread nodules, almost like tophi,under the dermis across the abdomen, but also in other areas of the trunk. The solid nodules are 2-3mm in diameter and about 5mm apart. they feel almost like a form of pox but they are only evident on palpation and do not rise above the skin surface. Do you have any idea what these nodules may be
Submitted: 2 months ago.
Category: Dermatology
Expert:  Shantal-Mod replied 2 months ago.
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Expert:  Dr. David replied 2 months ago.

This is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 2 months ago.

these bumps could be early Dermatitis herpetiformis of the skin which can be seen in patients who have celiac disease

or they could be milia or subcutaneous keritin depositis

a skin biopsy could help with diagnosis.

this 12 year old patient sounds like he or she is suffering quite a bit.

let me know if you have questions.

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