Dermatitis herpetiformis in Adult
The disease manifests as an intermittent pruritic papulovesicular eruption over the extensor surfaces of the extremities. Many patients who adhere to a strict gluten-free diet experience complete remission of their disease. Patients with DH are at an increased risk of developing Hashimoto thyroiditis, insulin-dependent diabetes mellitus, and enteropathy-associated T-cell lymphoma, and therefore warrant close surveillance.
A population-based study from Finland strongly suggests an increased risk of bullous pemphigoid in patients with dermatitis herpetiformis.
For more information, see OMIM.
L13.0 – Dermatitis herpetiformis
111196000 – Dermatitis herpetiformis
- Scabies manifests with interdigital burrows and involvement of the hands, wrists, and genital region, sparing the head.
- Papular urticaria may be associated with arthropod bites and is distributed over exposed areas.
- Bullous pemphigoid presents with urticarial erythematous plaques and intact, tense bullae in older patients.
- Linear IgA bullous dermatosis presents with grouped vesicles and bullae, classically in an annular configuration.
- Atopic dermatitis is also pruritic, with ill-defined, weeping erythematous plaques.
- Herpes simplex virus has nonsymmetric, localized, clustered vesicles with more pain and less pruritus.
- Epidermolysis bullosa acquisita may have associated milia.
- Transient acantholytic dermatosis (Grover disease) is a pruritic papular eruption in the seborrheic regions of older men.
- Neurotic excoriations are distributed in areas within reach for the patient to scratch, and no primary lesions are appreciated on exam.
- Pemphigoid gestationis is characterized by tense bullae over the abdomen in pregnant women.
- Chronic prurigo consists of lichenified excoriated papules or nodules.
- Prurigo pigmentosa usually affects the back, chest, and neck; the forehead and arms are rarely involved.
- Evaluate for other causes of pruritus.