Review: dermatitis herpetiformis

Abstract

Dermatitis herpetiformis (DH) or Duhring-Brocq disease is a chronic bullous disease characterized by intense itching and burning sensation in the erythematous papules and urticarial plaques, grouped vesicles with centrifuge growth, and tense blisters. There is an association with the genotypes HLA DR3, HLA DQw2, found in 80-90% of cases. It is an IgA-mediated cutaneous disease, with immunoglobulin A deposits appearing in a granular pattern at the top of the dermal papilla in the sublamina densa area of the basement membrane, which is present both in affected skin and healthy skin. The same protein IgA1 with J chain is found in the small intestinal mucosa in patients with adult celiac disease, suggesting a strong association with DH. Specific antibodies such as antiendomysium, antireticulina, antigliadin and, recently identified, the epidermal and tissue transglutaminase subtypes, as well as increased zonulin production, are common to both conditions, along with gluten-sensitive enteropathy and DH. Autoimmune diseases present higher levels of prevalence, such as thyroid (5-11%), pernicious anemia (1-3%), type 1 diabetes (1-2%) and collagen tissue disease. The chosen treatment is dapsone and a gluten-free diet.

Dermatitis herpetiformis: celiac disease of the skin. Report of two cases

“…In addition, excoriations, hyperpigmented scars may be present, because these lesions have periods of remission [1][2][3][4][5][6][7][8][9][10].…”

“…In 1888 Brocq described similar lesions diagnosed as "pruritic polymorphic dermatitis" [4]. It is also known as Duhring-Brocq disease [2][3][4].…”

“…It is also known as Duhring-Brocq disease [2][3][4]. However, the association of celiac disease, gluten-sensitive enteropathy and dermatitis herpetiformis was observed by Mards, Fry and Shuster in the 1960s [4].…”

Immunohistochemistry studies in a case of dermatitis herpetiformis demonstrate complex patterns of reactivity

“…In some clinical cases, a gluten-free diet may ameliorate the disease. The treatments of choice are dapsone and sulfones [6,7].…”

Letter to Editor About “Dermatitis Herpetiformis, the Celiac Disease of the Skin!”

“…The skin biopsy for H&E sections should come from a new, intact bulla, but for the DIF perile sional skin was ideal. Since it is well known that DIF deposits can only be irradicated through a glutenfree diet for several years (1,2) , sampling and DIF technique may be a problem in our group. As reported in the literature, thyroid disease was seen in two cases and type I diabetes in one case.…”