Dermatitis herpetiformis

Background

Normal dermal anatomy.

• Autoimmune disorder associated gluten sensitivity

Dermatitis Types

• Atopic dermatitis
• Candida dermatitis
• Cercarial dermatitis
• Contact dermatitis
  • Poison Oak, Ivy, Sumac dermatitis
• Dermatitis herpetiformis
• Diaper dermatitis
• Dyshidrotic dermatitis
• Neonatal seborrhoeic dermatitis
• Nummular dermatitis
• Perianal streptococcal dermatitis
• Perioral dermatitis
• Seborrheic dermatitis
• Stasis dermatitis

Clinical Features

Characteristic rash

• Looks like scabies, but clustered around elbows, knees, shoulders, buttox

Differential Diagnosis

• Scabies

Vesiculobullous rashes

Febrile

• Diffuse distribution
  • Varicella (chickenpox)
  • Smallpox
  • Monkeypox
  • Disseminated gonococcal disease
  • DIC
  • Purpural fulminans
• Localized distribution
  • Necrotizing fasciitis
  • Hand-foot-and-mouth disease

Afebrile

• Diffuse distribution
  • Bullous pemphigoid
  • Drug-Induced bullous disorders
  • Pemphigus vulgaris
  • Phytophotodermatitis
  • Erythema multiforme major
  • Bullous impetigo
• Localized distribution
  • Contact dermatitis
  • Herpes zoster (shingles)
  • Dyshidrotic eczema
  • Burn
  • Dermatitis herpetiformis
  • Erythema multiforme minor
  • Poison Oak, Ivy, Sumac dermatitis
  • Bullosis diabeticorum
  • Bullous impetigo
  • Folliculitis

Management

• Gluten-free diet
• Dapsone

Antibiotic Dosing

• Dapsone 50mg PO QD

See Also

• Rash