dermatologic disorders
Dermatitis Herpetiformis
Introduction
Dermatitis herpetiformis is an intensely pruritic, chronic, autoimmune, papulovesicular cutaneous eruption strongly associated with celiac disease. Typical findings are clusters of intensely pruritic, erythematous, urticarial lesions, as well as vesicles, papules, and bullae, usually distributed symmetrically on extensor surfaces. Diagnosis is by skin biopsy with direct immunofluorescence testing. Treatment is usually withdapsoneor sulfapyridine and a gluten-free diet. Dermatitis herpetiformis often occurs in young adults but can occur in children and older people. It is rare in blacks and Asians. Almost all patients with dermatitis herpetiformis have Celiac Disease histologically, but in most cases the celiac disease is asymptomatic. Dermatitis herpetiformis develops in 15 to 25% of patients with celiac disease. Patients may have a higher incidence of other autoimmune disorders (including thyroid disorders, pernicious anemia, and diabetes) and The termherpetiformisrefers to the clustered appearance of the lesions (similar to that seen in herpesvirus infection) but does not indicate a causal relationship to herpesvirus. 