A successfull treatment of a rare case of dermatitis herpetiformis

Dermatitis herpetiformis (DH) is a rare autoimmune bullous disease characterized by intensely pruritic, chronic, and recurrent vesicles on extensor surfaces such as the elbows, knees, and buttocks. There is a genotype relationship with HLA-DR3, HLA DQw2, discovered about 80-90% of cases. Immunoflorescence is the gold standard for diagnosis, but serologic testing can help if immunofluorescence result is negative. On histopathological examination, at the tips of papillary dermis, a collection of neutrophils are found and granular immunoglobulins A. Dermatitis herpetiformis associated with gluten intolerance (celiac disease), although the mechanism is not fully understood. Patients with gluten free diet will reduce of this disease both in the skin and intestinal tract, thereby reducing risk of lymphoma progression. Dapsone is the main therapy, but it require monitoring side effects.