DERMATITIS HERPETIFORMIS IN CHILDREN – A DIAGNOSIS TO KEEP IN MIND
Introduction: Dermatitis herpetiformis is a chronic, pruritic, polymorphous dermatosis, considered the cutaneous equivalent of coeliac disease. In pediatric patients, differential diagnosis with other more common dermatosis makes this a challenging diagnosis.
Case Report: We present the case of an 8-year old male patient, with polymorphous, pruritic lesions on the extensor surfaces of limbs, evolving for 2 years. Lesional skin biopsy showed neutrophils on the tips of the dermal papillae, and direct immunofluorescence of perilesional skin demonstrated granular deposits of IgA also on the tips of the dermal papillae, establishing the diagnosis of dermatitis herpetiformis. Subsequent studies confirmed the association to celiac disease and the adoption of a gluten-free diet led to the clinical resolution of both cutaneous lesions and enteropathy.
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