Dermatitis Herpetiformis

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Dermatitis herpetiformis (DH) is a condition characterized by pruritic papulovesicular skin lesions in which granular or linear IgA deposits are found at the dermal-epidermal junction [10]. The majority of patients with DH have the characteristic findings of celiac disease in small bowel biopsy specimens, although relatively few have GI symptoms. DH patients have similar HLA profiles to celiac patients and develop similar antibody elevations to gliadin and tissue transglutaminase (tTG). They are also at increased risk of malignancies as discussed later. Institution of a gluten-free diet will reverse both the skin and intestinal lesions, while standard therapies for DH such as dapsone improve only skin disease. It is not clear why only a small subset of celiacs has DH, while virtually all DH patients have the intestinal pathology of celiac disease.

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