Guidelines for the diagnosis and treatment of dermatitis herpetiformis

@article{Caproni2009GuidelinesFT,
  title={Guidelines for the diagnosis and treatment of dermatitis herpetiformis},
  author={Marzia Caproni and Emiliano Antiga and Lucilla Melani and Paolo Fabbri},
  journal={Journal of the European Academy of Dermatology and Venereology},
  year={2009},
  volume={23}
}
Dermatitis herpetiformis is a rare disease that should be considered the cutaneous expression of a gluten‐sensitive enteropathy indistinguishable from celiac disease. Dermatitis herpetiformis is often misdiagnosed and to date no guidelines for the management of dermatitis herpetiformis have been published in Literature. The present guidelines have been prepared for dermatologists by the Group for Cutaneous Immunopathology of the Italian Society of Dermatology and Venereology. They reflect the… 
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175 Citations
Highly Influential Citations
7
Background Citations
45
Methods Citations
5
Results Citations
2

175 Citations

Guidelines for the management of dermatitis
TLDR
Dapsone should be used during the acute presentation until the gluten free diet is effective and the diagnosis of dermatitis herpetiformis is made clinically, histologically, immunopathologically and supported by serology.
[Clinical guidelines for the diagnosis and treatment of dermatitis herpetiformis].
The diagnosis and treatment of dermatitis herpetiformis
TLDR
Although DH is a rare autoimmune disease with specific immunopathological alterations at the skin level, its importance goes beyond the skin itself and may have a big impact on the general health status and the quality of life of the patients.
Dermatitis herpetiformis Duhring as one of the forms of gluten-associated pathology: a review of the literature and a description of a clinical case
TLDR
It is shown that drug therapy without a gluten-free diet cannot be considered effective, and that the diet for dermatitis herpetiformis, like that for celiac disease, is lifelong.
[Dermatitis herpetiformis].
Dermatitis Herpetiformis: An Update on Diagnosis, Disease Monitoring, and Management
TLDR
A gluten-free diet and dapsone are still mainstays of treatment, but other medications may be necessary for recalcitrant cases, as well as methods used to monitor its disease course.
A successfull treatment of a rare case of dermatitis herpetiformis
TLDR
Dermatitis herpetiformis associated with gluten intolerance (celiac disease), although the mechanism is not fully understood, will reduce of this disease both in the skin and intestinal tract, thereby reducing risk of lymphoma progression.
Treatment of Dermatitis Herpetiformis
This chapter summarizes the current evidence-based treatment for dermatitis herpetiformis (DH). DH is an autoimmune blistering disorder characterized by pruritic papulovesicles on the extensor…
Homeopathy in the Treatment of Dermatitis Herpetiformis—A Case Presentation
TLDR
A case of histopathologically confirmed DH, successfully treated with homeopathy, is presented and the homeopathic medicine Aurum metallicum at MK potency was used.
Dermatitis herpetiformis.
TLDR
Gluten free diet (GFD) is the first-line therapeutic approach that can alleviate both cutaneous and intestinal manifestations of this condition, while dapsone and sulfones target the skin eruption only.
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References

SHOWING 1-10 OF 52 REFERENCES
Dermatitis herpetiformis: diagnosis, diet and demography.
TLDR
It is concluded that a gluten free diet is of therapeutic benefit in dermatitis herpetiformis and that spontaneous remission is uncommon in those not on a diet.
Dermatitis herpetiformis: problems, progress and prospects.
  • L. Fry
  • Medicine
    European journal of dermatology : EJD
  • 2002
TLDR
The demonstration that DH patients also have coeliac diseases and that the rash is also gluten dependent makes it possible to cure patients by gluten withdrawal from the diet, and the presence of IgA in the uninvolved is used as the diagnostic criterion for the disease.
Dermatitis herpetiformis: close to unravelling a disease.
  • S. Kárpáti
  • Medicine, Biology
    Journal of dermatological science
  • 2004
Dermatitis herpetiformis: an evaluation of diagnostic criteria
TLDR
Forty‐two patients in whom a clinical diagnosis of dermatitis herpetiformis had been, made, were studied and the response of the skin eruption to dapsone was noted.
Celiac disease serology in dermatitis herpetiformis. Which is the best option for detecting gluten sensitivity?
TLDR
The detection of a-GDP antibodies was the most reliable tool in order to identify gluten sensitivity in DH patients presenting a wide range of intestinal damage.
Details of the gluten-free diet for the patient with dermatitis herpetiformis.
A case of dermatitis herpetiformis with IgA endomysial antibodies but negative direct immunofluorescent findings.
TLDR
Findings on autoantibodies to tTG, an enzyme that metabolizes gliadin, points to a role of tTG in the immunopathology of gluten-sensitive enteropathy and helps to explain the need for a gluten-free diet in the management of DH cases.
A new model for dermatitis herpetiformis that uses HLA-DQ8 transgenic NOD mice.
TLDR
A novel mouse model for DH is described that utilizes the NOD background and the HLA-DQ8 transgene to determine the specificity of the IgA deposits, as well as the pathogenic mechanisms that occur in the skin as a result of gluten ingestion.
25 years' experience of a gluten‐free diet in the treatment of dermatitis herpetiformis
TLDR
Of the 77 patients taking a normal diet, eight entered spontaneous remission, giving a remission rate of 10%; a further two patients who had been taking gluten‐free diets were found to have remitted when they resumed normal diets.
Dermatitis herpetiformis and partial IgA deficiency.
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