Introduction

Dermatitis herpetiformis is an autoimmune blistering skin disorder associated with coeliac disease.

Epidemiology

  • Incidence: 1.00 cases per 100,000 person-years
  • Peak incidence: 30-40 years
  • Sex ratio: more common in males 2:1
Condition Relative
incidence
Shingles180.00
Dermatitis herpetiformis1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Pathophysiology

It is caused by deposition of IgA in the dermis.

Clinical features

Features
  • itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

© Image used on license from DermNet NZ and with the kind permission of Prof Raimo Suhonen

© Image used on license from DermNet NZ

Investigations

Diagnosis
  • skin biopsy: direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis

Management

Management
  • gluten-free diet
  • dapsone