Dermatitis herpetiformis in Child
The cutaneous lesions seen in childhood are similar to those in adults. The disease manifests as a symmetric papulovesicular eruption on the extensor surfaces and buttocks that is extremely pruritic and that may wax and wane in severity. Facial lesions have been reported. Rare presentations include nonpruritic inflammatory papules and pruritic purpuric macules and papules on the palms.
In children with DH, 80%-95% will have an associated gluten-sensitive enteropathy on small intestine biopsy. Interestingly, the enteropathy is typically asymptomatic upon presentation. Only 10% of children carry a previous diagnosis of celiac sprue.
There is an increased incidence of autoimmune diseases in patients with DH. The most common associated autoimmune conditions include Hashimoto thyroiditis, type I diabetes mellitus, and pernicious anemia. Patients with both celiac sprue and DH are at an increased risk of developing enteropathy-associated T-cell lymphoma. However, a gluten-free diet is protective against cancer development.
For more information, see OMIM.
L13.0 – Dermatitis herpetiformis
111196000 – Dermatitis herpetiformis
- Chronic bullous disease of childhood (linear IgA bullous dermatosis)
- Neurotic excoriations
- Papular urticaria
- Insect bite reactions
- Atopic dermatitis (eczematous dermatitis)
- Herpes simplex virus
- Epidermolysis bullosa simplex
- Chronic prurigo
- Polymorphous light eruption
- Pityriasis lichenoides et varioliformis acuta
- Child abuse
- Epidermolysis bullosa acquisita
- Prurigo pigmentosa