Gluten-free diet is beneficial in
Maintaining a gluten-free diet is the only sustainable method of eliminating the disease, not only from the skin, but also from the GI mucosa. Patients on a gluten-reduced diet may experience a decrease in symptoms; therefore, such a diet can reduce the dosage of dapsone required for disease control. Dermatitis herpetiformis:Also called Duhring-Brocq disease It is a autoimmune blistering skin condition, characterized by blisters filled with a watery fluid that is intensely itchy. DH is a cutaneous manifestation of Coeliac disease. DH is neither related to nor caused by herpes virus: the name means that it is a skin inflammation having an appearance similar to herpes. The age of onset is usually about 15-40, but DH also may affect children and the elderly. Men are slightly more affected than women. Estimates of DH prevalence vary from 1 in 400 to 1 in 10,000. It is most common in patients of nohern European/nohern Indian ancestry, and is associated with the human leukocyte antigen (HLA) haplotype HLA-DQ2 or HLA-DQ8 along with coeliac disease and gluten sensitivity. Histopathology shows a split in dermoepidermal junction i.e subepidermal split and bulla is filled with eosinophills, varying number of neutrophils and lymphocytes. Diagnostic finding is the deposition of IgA in the papillary dermis in a granular or fibrillar pattern in immunofluoroscence Dapsone is the DOC.Gluten-free diet is also first-line therapy Ref Harrison 20th edition pg 1326
Dermatitis herpetiformis
Pemphigus vulgaris
Psoriasis
Exfoliative dermatitis
Anatomy of skin