I have dermatitis herpetiformis for six years. Will long term Dapsone intake cause resistance?

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Dermatitis herpetiformis is associated with gluten-sensitive enteropathy. Immunological response to chronic stimulation of gut mucosa by dietary gluten plays a significant role in the induction and persistence of disease. The major auto-antigen associated is epidermal transglutaminase. Autoimmune factors, genetics, and environmental factors play a role. Other environmental factors that trigger DH are the ingestion of gluten (cereals such as wheat, rice, and barley). Also, iodine-containing diets such as shellfish, exposure to iodine during surgical procedures can induce flare-ups. Do you have a pruritic rash or intense itching? What is the extent of involvement? Do you have erythematous papules, hives, or vesicles? Are your iron and folate levels equals? Do you have B12 or zinc deficiencies, abdominal discomfort, or any autoimmune disorder? A gluten-free diet is the treatment of choice for DH. After 1 or 2 years, it may reduce or eliminate the need for medication. It is wise to start the dose at 25 to 50 mg in adults and slowly increase the dose that keeps patients comfortable and without significant side effects. Regular follow-up is required with the blood report in the first three months of Dapsone therapy. Topical steroids can be used in reducing the symptoms. Do you have any lesions?