Article information
Abstract
Dermatitis herpetiformis is an autoimmune blistering disease that appears as a cutaneous manifestation of gluten intolerance. It is one of a group of disorders that have gluten sensitivity in common, including celiac disease and gluten ataxia. Patients with dermatitis herpetiformis present with a pruritic papulovesicular rash on extensor surfaces and on the buttocks. Immunological studies demonstrate the presence of specific immunoglobulin (Ig) A antiendomysial and antitransglutaminase antibodies. The finding of granular deposits of IgA along the dermal-epidermal junction is pathognomonic of dermatitis herpetiformis. Treatment of dermatitis herpetiformis is based on a life-long, strict gluten-free diet, which improves all clinical aspects of gluten sensitivity, and dapsone, a drug that is only effective for the skin manifestations.
Keywords:
Celiac disease
Dapsone
Dermatitis herpetiformis
Duhring disease
Gluten
Resumen
La dermatitis herpetiforme es una enfermedad ampollosa autoinmune que aparece como expresión cutánea de la intolerancia al gluten. Forma parte de un abanico de patologías que tienen en común la sensibilidad a este componente, entre las cuales se encuentra la celiaquía y la ataxia por gluten. Los pacientes con dermatitis herpetiforme presentan una erupción papulovesicular pruriginosa de predominio en superficies de extensión y nalgas. El estudio inmunológico demuestra la presencia de anticuerpos específicos IgA antiendomisio y antitransglutaminasa. El hallazgo de depósitos granulares de IgA en la unión dermoepidérmica es patognomónico de la dermatitis herpetiforme. El tratamiento se basa en dos pilares: mantener indefinidamente una dieta estricta libre de este componente (la cual mejora todas las formas clínicas de la sensibilidad al gluten) y la dapsona, fármaco que es eficaz solo para las manifestaciones cutáneas.
Palabras clave:
Celiaquía
Dapsona
Dermatitis herpetiforme
Enfermedad de Duhring
Gluten
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