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Dermatitis herpetiformis

Dermatitis herpetiformis (DH) is an itchy, blistering skin condition connected to gluten intolerance. This autoimmune disease sees gluten-causing skin lesions, with the rash often appearing on areas like the elbows and knees. Diagnosing DH typically involves skin tests, and the condition often sees improvement with a gluten-free diet. The disease is most common in Caucasians between ages 15-50.

Aspect/FeatureDescription
NatureChronic, autoimmune, blistering disease. Linked to gluten-sensitive enteropathy (GSE).
Primary CausesGluten hypersensitivity induces an inflammatory cascade, forming skin lesions.
Clinical PresentationItchy, vesico-bullous lesions primarily on elbows, knees, and buttocks. Symptoms can range from vesicles to intensely itchy papules.
DistributionLesions predominantly appear on the scalp, shoulders, buttocks, elbows, and knees.
Main CharacteristicsIgA deposits found on the dermal papillae; mainly observed on extensor surface of limbs, buttocks, and the scapular area.
Lesion FeaturesBlisters often form on reddened skin, but they may erode due to scratching. Lesions can resemble various other skin conditions.
Itchiness & Skin ChangesIntense itching is common; postinflammatory skin changes include hypopigmentation or hyperpigmentation.
Resemblance to Other ConditionsMight mimic conditions like dermatitis, scabies, and papular urticaria.
DiagnosisGold-standard is immunofluorescence of perilesional skin. Serological tests aid when primary tests are inconclusive.
Treatment...

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