- Dermatitis herpetiformis is an uncommon, symmetrical vesiculo-bullous disorder which mainly affects the extensor surfaces.
- Usually presents in 3rd/4th decade and more common in men (2:1).
- Most cases are associated with Coeliac disease (jejunal villous atrophy) (1 in 10 will also have a family history)
- NB symptoms of this may be mild or even absent
- Anti-endomysial antibodies are usually present and skin biopsy often shows IgA deposition along the dermal papillae
- Blisters are rarely found intact (usually excoriated) commonly on the knees, elbows, buttock, scalp and, occasionally, trunk
- Extremely itchy
- Skin may be normal or erythematous
- As for coeliac i.e. antiendomysial antibody, gliadin antibody
- May also have a mild anaemia (may be micro-, macro-, or normo-cytic)
- Immunofluorescence (IgA deposition)
- Gluten free diet
- Dapsone (antimicrobial cream)
- Or ultrapotent steroids