A rare case of Dermatitis Herpetiformis in a 37-year-old Filipino female

Authors: Crystal Karen G. Retuya, MD, Maria Jasmin J. Jamora, MD, FPDS

Abstract

Introduction: Dermatitis Herpetiformis is a subepidermal blistering disease that can be confirmed by histologic, immunologic, and gastrointestinal criteria. It occurs most commonly in individuals of Northern European descent and is in uncommon in Asians. Incidence rates are between 0.4 to 3.5 per 100,000 people per year worldwide and is associated with the HLA DQ2 and HLA DQ8 haploptype.

Case Summary: A 37 year-old Filipino female presented with a 3- month history of an itchy red rash and fluid filled blisters on the upper back, eventually spreading to the entire body. Appearance of the rash was noted to be related to intake of gluten-containing food. A sample lesion was sent for biopsy which showed subepidermal vesicobullous dermatitis, inflammatory, predominantly neutrophilic. Direct Immunofluorescence confirmed the diagnosis of Dermatitis Herpetiformis.

Conclusion: Dermatitis herpetiformis is an uncommon cutaneous disorder that is a manifestation of gluten sensitivity. Histopathologic confirmation and Direct Immunofluorescence is critical in the diagnosis of this disease. It is usually a life-long condition that requires continuous treatment, and the role of the dermatologist is of greatest importance in the recognition and monitoring of development of associated diseases.

 

Citation

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Keywords

Dermatitis herpetiformis, Immunofluorescence, gluten sensitivity

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