TY - CHAP M1 - Book, Section TI - Dermatitis Herpetiformis A1 - Shinkai, Kanade A1 - Fox, Lindy P. A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. Y1 - 2023 N1 - T2 - Current Medical Diagnosis & Treatment 2023 AB - Dermatitis herpetiformis is an uncommon disease manifested by intensely pruritic papules, vesicles, and papulovesicles mainly on the elbows, knees, buttocks, posterior neck, and scalp (eFigure 6–89). It has the highest prevalence in Northern Europe and is associated with HLA antigens -B8, -DR3, and -DQ2. The histopathology is distinctive. Circulating antibodies to tissue transglutaminase are present in 90% of cases. NSAIDs may cause flares. Patients may have gluten-sensitive enteropathy. Three-fourths of patients have villous atrophy on small bowel biopsy; however, GI symptoms are subclinical in most. The prevalence of dermatitis herpetiformis to celiac disease is 1:8. Ingestion of gluten is the cause of dermatitis herpetiformis, and strict long-term avoidance of dietary gluten may eliminate the need for treatment or decrease the dose of dapsone (initial treatment dose is 100–200 mg orally daily) required to control the disease. Patients with dermatitis herpetiformis are at increased risk for GI lymphoma, and this risk is reduced by a gluten-free diet. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/09/20 UR - accessmedicine.mhmedical.com/content.aspx?aid=1193628729 ER -