Dermatitis herpetiformis

Dermatitis herpetiformis


DERMATITIS HERPETIFORMIS

Signs and Symptoms:

  • Intensely itchy vesicles, papulovesicles and urticaria papules symmetrically distributed over extensor surfaces (elbows, knees, buttocks, back, scalp, and posterior neck)
  • Almost all have an associated, usually subclinical, gluten-sensitive enteropathy
Pathophysiology and Diagnosis:

  • >90% express the HLA-B8/DRw3 and HLA-DQw2 haplotypes
  • Biopsy of new lesions – vesicle forms subepidermally and develops from collections of inflammatory cells in the papillary tips (the papillary tip abscess)
  • Direct IF- presence of IgA in the papillary tips in the skin around the lesions

Treatment:

  • Gluten-free diet
  • Dapsone therapy
  • Patients are at increased risk for development of gastrointestinal lymphoma

Exam Question

  • Intensely itchy vesicles, papulovesicles and urticaria papules symmetrically distributed over extensor surfaces (elbows, knees, buttocks, back, scalp, and posterior neck)
  • Almost all have an associated, usually subclinical, gluten-sensitive enteropathy 
  • >90% express the HLA-B8/DRw3 and HLA-DQw2 haplotypes
  • Biopsy of new lesions – vesicle forms subepidermally and develops from collections of inflammatory cells in the papillary tips (the papillary tip abscess)
  • Direct IF- presence of IgA in the papillary tips in the skin around the lesions
  •  Gluten-free diet
  • Dapsone therapy
  • Patients are at increased risk for development of gastrointestinal lymphoma
Don’t Forget to Solve all the previous Year Question asked on Dermatitis herpetiformis

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