This patient had a long history of coeliac disease (CD). The boy was diagnosed with acute CD within his first year of life and was treated by gluten-free diet (GFD) by the pediatric gastroenterology department. He had no further major medical problems before puberty when he felt unwell and different, and started to eat some gluten containing food when he was with friends or joined to companies. Although he was controlled for the CD, and he did not have clinical symptoms, he gradually developed an intermittent, itchy, commonly crusted, “allergic” rash above the elbows, buttocks, knees and above the shoulders. He was 18 when seen at the dermatology department with classical DH (Fig. 15.2), which was confirmed by skin histology and immunofluorescence. At that time his endomysium antibody (EMA) was positive. Under strict GFD he slowly became free of skin symptoms. There was no CD in the family by serological screening at that time, but anti-thyroid antibodies were identified in the patient without a functional endocrinological defect.