A 30 year old male presents with itchy papulo-vesicular lesions on the extremities, knees, elbows and buttocks since one year. Direct immunofluorescence staining of the lesions showed IgA deposition at dermoepidermal junction. Which of the following represents the most probable diagnosis?
Patient is showing features of dermatitis herpetiformis. Dermatitis herpetiformis is a chronic, intensely itchy blistering disease characterized by the presence of papules and vesicles occurring predominantly on the extensor surfaces of the body such as the elbows, knees, buttocks and scapula. It is seen in association with gluten sensitive enteropathy. Diagnosis is made by the presence of IgA deposits in the dermoepidermal junction by direct immunoflouresence examination of a perilesional or normal appearing skin biopsy sample. Treatment includes dapsone and gluten free diet. Ref: NORD Guide to Rare Disorders: National Organization for Rare Disorders, Page 103; Atlas of Clinical Dermatology By Anthony Du Vivier, 3rd Edition, Pages 418, 426; Dermatology in Clinical Practice By S. W. Lanigan, Page 170
Pemphigus vulgaris
Bullous pemphigoid
Dermatitis herpetiformis
Nummular eczema