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The diagnosis and treatment of dermatitis herpetiformis

Dermatitis herpetiformis (DH) is an inflammatory cutaneous disease with a chronic relapsing course, pruritic polymorphic lesions, and typical histopathological and immunopathological findings. According to several evidences, DH is considered the specific cutaneous manifestation of celiac disease, an...

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Autores principales: Antiga, Emiliano, Caproni, Marzia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435051/
https://www.ncbi.nlm.nih.gov/pubmed/25999753
http://dx.doi.org/10.2147/CCID.S69127
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author Antiga, Emiliano
Caproni, Marzia
author_facet Antiga, Emiliano
Caproni, Marzia
author_sort Antiga, Emiliano
collection PubMed
description Dermatitis herpetiformis (DH) is an inflammatory cutaneous disease with a chronic relapsing course, pruritic polymorphic lesions, and typical histopathological and immunopathological findings. According to several evidences, DH is considered the specific cutaneous manifestation of celiac disease, and the most recent guidelines of celiac disease have stated that, in celiac patients with a proven DH, a duodenal biopsy is unnecessary for the diagnosis. In this review, the most recent data about the diagnosis and the management of DH have been reported and discussed. In particular, in patients with clinical and/or histopathological findings suggestive for DH, the finding of granular IgA deposits along the dermal–epidermal junction or at the papillary tips by direct immunofluorescence (DIF) assay, together with positive results for anti-tissue transglutaminase antibody testing, allows the diagnosis. Thereafter, a gluten-free diet should be started in association with drugs, such as dapsone, that are able to control the skin manifestations during the first phases of the diet. In conclusion, although DH is a rare autoimmune disease with specific immunopathological alterations at the skin level, its importance goes beyond the skin itself and may have a big impact on the general health status and the quality of life of the patients.
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spelling pubmed-44350512015-05-21 The diagnosis and treatment of dermatitis herpetiformis Antiga, Emiliano Caproni, Marzia Clin Cosmet Investig Dermatol Review Dermatitis herpetiformis (DH) is an inflammatory cutaneous disease with a chronic relapsing course, pruritic polymorphic lesions, and typical histopathological and immunopathological findings. According to several evidences, DH is considered the specific cutaneous manifestation of celiac disease, and the most recent guidelines of celiac disease have stated that, in celiac patients with a proven DH, a duodenal biopsy is unnecessary for the diagnosis. In this review, the most recent data about the diagnosis and the management of DH have been reported and discussed. In particular, in patients with clinical and/or histopathological findings suggestive for DH, the finding of granular IgA deposits along the dermal–epidermal junction or at the papillary tips by direct immunofluorescence (DIF) assay, together with positive results for anti-tissue transglutaminase antibody testing, allows the diagnosis. Thereafter, a gluten-free diet should be started in association with drugs, such as dapsone, that are able to control the skin manifestations during the first phases of the diet. In conclusion, although DH is a rare autoimmune disease with specific immunopathological alterations at the skin level, its importance goes beyond the skin itself and may have a big impact on the general health status and the quality of life of the patients. Dove Medical Press 2015-05-13 /pmc/articles/PMC4435051/ /pubmed/25999753 http://dx.doi.org/10.2147/CCID.S69127 Text en © 2015 Antiga and Caproni. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Antiga, Emiliano
Caproni, Marzia
The diagnosis and treatment of dermatitis herpetiformis
title The diagnosis and treatment of dermatitis herpetiformis
title_full The diagnosis and treatment of dermatitis herpetiformis
title_fullStr The diagnosis and treatment of dermatitis herpetiformis
title_full_unstemmed The diagnosis and treatment of dermatitis herpetiformis
title_short The diagnosis and treatment of dermatitis herpetiformis
title_sort diagnosis and treatment of dermatitis herpetiformis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435051/
https://www.ncbi.nlm.nih.gov/pubmed/25999753
http://dx.doi.org/10.2147/CCID.S69127
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