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2011, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2011; 9 (3)

Dermatitis herpetiformis. A case report

Salas AJC, Gomez PMS, Cepeda VR
Full text How to cite this article

Language: Spanish
References: 10
Page: 186-189
PDF size: 138.61 Kb.


Key words:

Dermatitis herpetiformis, IgA, gluten, celiac disease.

ABSTRACT

Dermatitis herpetiformis is a chronic autoimmune blistering disease, first described in 1884 by Louis Duhring. It is characterized by erythematous plaques composed by papules and vesicles, some of them excoriated. The classical clinical presentation is on extensor surface of the extremities, but it can be generalized. Dermatitis herpetiformis is characterized by the deposition of immunoglobulin A (IgA) and transglutaminase 3 (TGe) complexes in the papillary dermis, as a result of chronic stimulation of the intestinal mucosa by dietary gluten, producing the typical lesions. The diagnosis is based on clinical appearance, and the histopathology findings in hematoxylin and eosin stain, and direct immunofluorescence showing deposition of IgA in a granular pattern in the papillary dermis. The treatment includes a gluten-free diet and dapsone, considered the first-line drug therapy. We discuss a 51-year-old female case, with dermatitis herpetiformis, and an excellent response to dapsone.


REFERENCES

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  3. Sardy M, Karpati S, Merkl B, Paulsson M, Smyth N. “Epidermal transglutaminase (TGase 3) is the autoantigen of dermatitis herpetiformis”. J Exp Med 2002; 195(6): 747-757.

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  6. Samolitis NJ, Hull CM, Leiferman KM, Zone JJ. “Dermatitis herpetiformis and partial IgA deficiency”. J Am Acad Dermatol 2006 May; 54 (5 Suppl): S206- S209.

  7. Fry L, Seah PP, Riches DJ, Hoffbrand AV. “Clearance of skin lesions in dermatitis herpetiformis after gluten withdrawal”. Lancet 1973; 1: 288- 291.

  8. Gaspari AA, Huang CM, Davey RJ, Bondy C, Lawley TJ, Katz SI. “Prevalence of thyroid abnormalities in patients with dermatitis herpetiformis and in control subjects with HLA-B8/-DR3”. Am J Med 1990 Feb; 88(2): 145-150.

  9. Sigurgeirsson B, Agnarsson BA, Lindelof B. “Risk of lymphoma in patients with dermatitis herpetiformis”. BMJ 1994 Jan 1; 308(6920): 13-15.

  10. Rose C, Armbruster FP, Ruppert J, Igl BW, Zillikens D, Shimanovich I. “Autoantibodies against epidermal transglutaminase are a sensitive diagnostic marker in patients with dermatitis herpetiformis on a normal or gluten-free diet”. J Am Acad Dermatol 2009 Jul; 61(1): 39-43.




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Dermatología Cosmética, Médica y Quirúrgica. 2011;9