Dermatitis herpetiformis

Abstract

Dermatitis herpetiformis is an immunobullous skin disease that is closely related to gluten sensitive enteropathy. Classic clinical characteristics of intensely pruritic vesiculopapules on the elbows, knees, and scalp are well defined, although some clinical variation exists. In most cases the diagnosis is firmly established by the presence of granular IgA in the dermal papillae on direct immunofluorescent studies. Sulfonamide compounds were first described as effective therapy several decades ago and remain the mainstay of medical therapy, while a strict gluten free diet will keep patients free of cutaneous manifestations in the majority of cases. Our understanding of dermatitis herpetiformis continues to grow, as does our understanding of the relationship between the gut and the skin.