1. [Dermatitis herpetiformis. A clinical chameleon].
- Author
-
Pfeiffer C
- Subjects
- Adolescent, Adult, Age Factors, Aged, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Biopsy, Celiac Disease diagnosis, Celiac Disease diet therapy, Celiac Disease immunology, Child, Child, Preschool, Dapsone therapeutic use, Diet standards, Enzyme-Linked Immunosorbent Assay, Female, Fluorescent Antibody Technique, Indirect, Glutens administration & dosage, Glutens immunology, Humans, Immunoglobulin A analysis, Male, Middle Aged, Risk Factors, Sex Factors, Skin pathology, Sulfonamides therapeutic use, Celiac Disease complications, Dermatitis Herpetiformis diagnosis, Dermatitis Herpetiformis diet therapy, Dermatitis Herpetiformis drug therapy, Dermatitis Herpetiformis epidemiology, Dermatitis Herpetiformis etiology, Dermatitis Herpetiformis immunology, Dermatitis Herpetiformis pathology
- Abstract
Celiac disease is a genetically determined bowel disease also influenced by exogenous factors in which exposure to grain components triggers a chronic immune response with intestinal symptoms. Dermatitis herpetiformis represents the cutaneous manifestation of celiac disease. While intense pruritus is the characteristic symptom, clinical signs can be highly variable, ranging from grouped papulovesicles with excoriations or eczema-like lesions to minimal variants of discrete erythema and digital purpura. Diagnosis depends on direct fluorescence studies of perilesional skin displaying granular IgA deposits in dermal papillae. Suspecting and then searching for dermatitis herpetiformis is often clinically challenging, as the disease is a true chameleon with many clinical faces. Dapsone therapy alleviates the cutaneous symptoms and signs, but does not prevent the systemic complications of celiac disease; thus, strict adherence to a gluten-free diet is strongly advisable.
- Published
- 2006
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