Dermatitis herpetiformis - Revision history

Danbot: Expand with concise EM-focused content: celiac association, DIF diagnosis, G6PD check before dapsone

2026-03-21T01:26:30Z

Expand with concise EM-focused content: celiac association, DIF diagnosis, G6PD check before dapsone

← Older revision		Revision as of 01:26, 21 March 2026
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	==Background==		==Background==
	{{Skin anatomy background images}}		{{Skin anatomy background images}}
	*Autoimmune disorder associated gluten sensitivity		*Autoimmune blistering skin disorder strongly associated with celiac disease (gluten sensitivity)
			*IgA deposits at dermal papillae cause neutrophilic inflammation
			*Nearly all patients (>90%) have underlying celiac disease on intestinal biopsy, though most are asymptomatic from GI perspective
			*Peak age: 30-40 years; male predominance

	{{Dermatitis types}}		{{Dermatitis types}}
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	==Clinical Features==		==Clinical Features==
	[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]		[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]
	*~~Looks like~~ [[scabies]], but ~~clustered around elbows, knees, shoulders, buttox~~		*Intensely pruritic papulovesicular eruption in '''symmetric''' distribution
			*Characteristic locations: elbows, knees, shoulders, buttocks, sacrum, scalp
			*Grouped vesicles on erythematous base (herpetiform pattern — hence the name, though unrelated to [[herpes]])
			*Excoriations often predominate (patients scratch off the vesicles)
			*Resembles [[scabies]] but distribution is more extensor surfaces

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Scabies]]		*[[Scabies]]
			*[[Linear IgA bullous dermatosis]]
			*[[Herpes simplex virus\|HSV]]
			*[[Contact dermatitis]]
	{{Bullous rashes DDX}}		{{Bullous rashes DDX}}

	==Evaluation==		==Evaluation==
			*Skin biopsy with direct immunofluorescence (gold standard): granular IgA deposits at dermal papillae
			*Tissue transglutaminase (tTG) IgA — elevated in most patients
			*Consider referral for intestinal biopsy to confirm celiac disease

	==Management==		==Management==
	*Gluten-free diet		*'''Gluten-free diet''' — mainstay of long-term treatment (improves skin and GI disease)
	*[[Dapsone]]		*'''[[Dapsone]]''' — rapid relief of symptoms (often within 24-48 hours)


	~~===Antibiotic Dosing===~~
	*{{AntibioticDose\|drug=Dapsone\|dose=50mg PO QD\|context=Dermatitis herpetiformis\|disease=Dermatitis herpetiformis\|population=Adult}}		*{{AntibioticDose\|drug=Dapsone\|dose=50mg PO QD\|context=Dermatitis herpetiformis\|disease=Dermatitis herpetiformis\|population=Adult}}
			*Check G6PD level before starting dapsone (risk of hemolytic anemia)
			*Monitor CBC regularly on dapsone therapy

	==Disposition==		==Disposition==
			*Discharge with dermatology referral
			*Consider GI referral for celiac disease evaluation

	==See Also==		==See Also==
	*[[Rash]]		*[[Rash]]
			*[[Celiac disease]]
			*[[Bullous pemphigoid]]

			==References==
			<references/>

	[[Category:Dermatology]]		[[Category:Dermatology]]

Danbot: Add Dapsone AntibioticDose entry

2026-03-20T10:58:34Z

Add Dapsone AntibioticDose entry

← Older revision		Revision as of 10:58, 20 March 2026
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	*Gluten-free diet		*Gluten-free diet
	*[[Dapsone]]		*[[Dapsone]]


			===Antibiotic Dosing===
			*{{AntibioticDose\|drug=Dapsone\|dose=50mg PO QD\|context=Dermatitis herpetiformis\|disease=Dermatitis herpetiformis\|population=Adult}}

	==Disposition==		==Disposition==

Rossdonaldson1: /* Background */

2024-12-11T16:20:12Z

Background

← Older revision		Revision as of 16:20, 11 December 2024
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	==Background==		==Background==
			{{Skin anatomy background images}}
	*Autoimmune disorder associated gluten sensitivity		*Autoimmune disorder associated gluten sensitivity

Rossdonaldson1 at 22:44, 10 September 2020

2020-09-10T22:44:56Z

← Older revision		Revision as of 22:44, 10 September 2020
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	{{Dermatitis types}}		{{Dermatitis types}}

	==~~Evaluation~~==		==Clinical Features==
	[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]		[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]
	*Looks like [[scabies]], but clustered around elbows, knees, shoulders, buttox		*Looks like [[scabies]], but clustered around elbows, knees, shoulders, buttox
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	{{Bullous rashes DDX}}		{{Bullous rashes DDX}}

			==Evaluation==

	==Management==		==Management==
	*Gluten-free diet		*Gluten-free diet
	*[[Dapsone]]		*[[Dapsone]]

			==Disposition==

	==See Also==		==See Also==
	[[Rash]]		*[[Rash]]

	[[Category:Dermatology]]		[[Category:Dermatology]]

Rossdonaldson1: /* Background */

2020-09-10T22:44:17Z

Background

← Older revision		Revision as of 22:44, 10 September 2020
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	==Background==		==Background==
	*Autoimmune disorder associated gluten sensitivity		*Autoimmune disorder associated gluten sensitivity

			{{Dermatitis types}}

	==Evaluation==		==Evaluation==

ClaireLewis: /* Management */

2019-09-27T20:46:25Z

Management

← Older revision		Revision as of 20:46, 27 September 2019
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	==Management==		==Management==
	*Gluten free diet		*Gluten-free diet
	*Dapsone		*[[Dapsone]]

	==See Also==		==See Also==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-25T19:31:01Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 19:31, 25 July 2016
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	*Autoimmune disorder associated gluten sensitivity		*Autoimmune disorder associated gluten sensitivity

	==~~Diagnosis~~==		==Evaluation==
	[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]		[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]
	*Looks like [[scabies]], but clustered around elbows, knees, shoulders, buttox		*Looks like [[scabies]], but clustered around elbows, knees, shoulders, buttox

Neil.m.young: Text replacement - "==Treatment==" to "==Management=="

2016-07-07T12:43:18Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 12:43, 7 July 2016
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	{{Bullous rashes DDX}}		{{Bullous rashes DDX}}

	==~~Treatment~~==		==Management==
	*Gluten free diet		*Gluten free diet
	*Dapsone		*Dapsone

Ostermayer: Text replacement - "Category:Derm" to "Category:Dermatology"

2016-03-22T13:14:06Z

Text replacement - "Category:Derm" to "Category:Dermatology"

← Older revision		Revision as of 13:14, 22 March 2016
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	[[Rash]]		[[Rash]]

	[[Category:~~Derm~~]]		[[Category:Dermatology]]

Rossdonaldson1 at 16:10, 25 January 2015

2015-01-25T16:10:04Z

← Older revision		Revision as of 16:10, 25 January 2015
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	==Diagnosis==		==Diagnosis==
	[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]		[[File:Dermatitis-herpetiformis2.jpg\|thumbnail\|Characteristic rash]]
	*Looks like scabies, but clustered around elbows, knees, shoulders, buttox		*Looks like [[scabies]], but clustered around elbows, knees, shoulders, buttox

			==Differential Diagnosis==
			*[[Scabies]]

			{{Bullous rashes DDX}}

	==Treatment==		==Treatment==