The pathogenesis of dermatitis herpetiformis

Abstract

The main feature of the hypothesis put forward here to explain DH is that DH has its origin in the associated GI lesion. In this hypothesis the only difference between ordinary GSE and the GSE associated with DH is in the distribution and/or presence of binding sites for gluten protein or IgA antibodies in different tissues. In GSE the GI tract is the main target organ and fixation of gluten protein on epithelial cells is assumed to be a major feature; this insures that GI epithelial cell cytotoxicity will dominate the clinical picture. On the other hand, in DH the skin is the major target organ because of gluten protein binding (or binding of other relevant materials) to skin structures.